Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | OP00000794 | WA |
NPI | 1144359571 |
---|---|
Provider Name | Raymond Edward Kania |
First Address | Pasco, WA 99301-6529 |
Second Address | Pasco, WA 99301-9189 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/07/2007 |