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General NPI Number Information
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NPI Number | 1972700284
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Entity Type | Organization
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Legal Business Name | TRI-CITIES COMMUNITY HEALTH
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 715 W COURT ST
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City | PASCO
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State | WA
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Zip | 99301
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Country | US
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Telephone | 509-547-2204
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1452
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City | PASCO
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State | WA
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Zip | 99301
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Country | US
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Telephone | 509-547-2204
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Fax | 509-542-8836
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Authorized Official
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Title or Position | CEO
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Name | KRISTY NEEDHAM
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Credential |
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Telephone | 509-547-2204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 126900000X
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Taxonomy Name | Dental Laboratory Technician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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