Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO 00000758 | WA |
NPI | 1033169925 |
---|---|
Provider Name | Dr. Rodney Allan Graves |
First Address | Kennewick, WA 99337-5092 |
Second Address | Richland, WA 99352-3304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 18/05/2021 |