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General NPI Number Information
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NPI Number | 1992970297
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Entity Type | Individual
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Provider Name | WILLIAM S. WAITES PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 3730 PLAZA WAY STE C6100
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City | KENNEWICK
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State | WA
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Zip | 99338-2718
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Country | US
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Telephone | 509-591-0070
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Fax | 509-396-9661
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Provider Business Mailing Address
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Address Line | 8524 W GAGE BLVD BLDG A-1 BOX 319
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City | KENNEWICK
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State | WA
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Zip | 99336-8241
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Country | US
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Telephone | 509-591-0070
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Fax | 509-396-9661
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10003522
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License Number State | WA
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