Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DE00009527 | WA |
NPI | 1083703086 |
---|---|
Provider Name | Dr. Craig D Ritchie |
First Address | Kennewick, WA 99336-7719 |
Second Address | Kennewick, WA 99336-7719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5036876 | (05) | WA |
5043344 | (05) | WA |
BR8184830 | DEA (01) | WA |
CS10000341 | CONSCIOUS SEDATION (01) | WA |