Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | DOL.OL.60952801 | WA |
Y | 111NI0900X | Internist | DOL.OL.60952801 | WA |
NPI | 1003341983 |
---|---|
Provider Name | Joel Ohrt |
First Address | Kennewick, WA 99336 |
Second Address | Kennewick, WA 99336-6304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2017 |
Last Update Date | 24/07/2019 |