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Contact Information

KENNEWICK RADIOLOGY GROUP PC
174 FIRST AVENUE NORTH
ILWACO, WA98624
 Phone: 360-642-6304
 Fax: 360-642-6309
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for KENNEWICK RADIOLOGY GROUP PC · (Female)

NPI Number 1437328085
Status Active
Credentials
Entity Individual
Enumeration date 02/28/2008
Last updated 05/01/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR Medicaid 006814
  • WA Medicaid 7138209
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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