Mendoza, Raul
Mendoza, Raul is an individual health care provider with primary practice located at 1515 E Columbia St , Othello WA 99344-1846. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Mendoza, Raul can be contacted via phone (509) 488-5256.Contact Information
Primary practice address
1515 E Columbia St
Othello WA 99344-1846
Phone: (509) 488-5256
Fax: (509) 488-9939
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA60425763 | Washington |
Profile Details
| NPI number | 1760805568 |
|---|---|
| LBN Legal business name | Mendoza, Raul |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 29th, 2014 |
| Last updated | Feb 17th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760805568 | NPPES |
| Washington | MEDICAID | 2034154 |
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