=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326355314
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARWAN QATTAN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2010
-----------------------------------------------------
Last Update Date | 05/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1100 GOETHALS DR STE F
-----------------------------------------------------
City | RICHLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99352-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-942-3272
-----------------------------------------------------
Fax | 509-942-3273
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 550 GAGE BLVD STE 101
-----------------------------------------------------
City | RICHLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99352-9532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-473-0637
-----------------------------------------------------
Fax | 509-627-2983
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | MD194051
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | MD194051
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | MD61201374
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 125057435
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | MD61201374
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------