Active NPI 1619105004 Individual Practitioner Male Practitioner

Dr. John-David Black , MD

Orthopaedic Surgery • Richland, WA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. John-David Black, MD is a certified Orthopaedic Surgery practicing in Richland, WA. With approximately 17 years of clinical experience since graduating from Ohio State University College Of Medicine in 2009, Dr. Black delivers high-quality medical care to the local community at 845 SWIFT BLVD.

Dr. Black is affiliated with Kadlec Regional Medical Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include x-ray of hip, 2-3 views, x-ray of pelvis, minimum of 3 views, mri scan of arm joint without contrast. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

845 Swift Blvd

Richland, WA 99352

Telephone 5099461654

Fax 5099435652

Associated Practice Facility / Clinic

🏢 Northwest Orthopaedic Associates, Pllc Facility NPI 1992772685

Medicare Profile & Education

Medical School

Ohio State University College Of Medicine

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Richland, WA

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

17 Yrs -2.2 yrs vs City Avg

City Avg: 19.2 Yrs

State Avg: 23.2 Yrs

Regional Practice Density

13 Specialists

Practicing in Richland, WA (707 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

66.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Black (17 Years) 17 Yrs

Richland Specialty Average (19.2 Years) 19.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
73502 X-ray of hip, 2-3 views	173	111	$174.00	$46.63
72190 X-ray of pelvis, minimum of 3 views	149	76	$184.00	$40.36
73221 Mri scan of arm joint without contrast	115	110	$899.00	$145.12
73552 X-ray of thigh bone, minimum 2 views	103	44	$112.00	$30.52
73610 X-ray of ankle, minimum of 3 views	81	36	$179.00	$32.89
76000 Imaging guidance for procedure, 60 minutes or less	70	66	$65.00	$14.43
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	69	69	$444.00	$164.97
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	62	62	$425.00	$169.00
99213 Established patient office or other outpatient visit, typically 15 minutes	59	50	$263.00	$90.84
73560 X-ray of knee, 1-2 views	49	26	$142.00	$32.03
73590 X-ray of lower leg, 2 views	48	18	$141.00	$28.50
27130 Replacement of thigh bone and hip joint with prosthesis	44	43	$2910.00	$1248.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	41	37	$317.00	$128.16
73721 Mri scan of leg joint without contrast	36	35	$899.00	$145.50
27279 Fusion of pelvic joint using imaging guidance	36	36	$1685.56	$820.99
73080 X-ray of elbow, minimum of 3 views	25	11	$141.00	$33.40
27245 Treatment of broken neck of thigh bone with bone implant	20	20	$2592.46	$1146.52
72148 MRI scan of lower spinal canal	17	17	$899.00	$129.71
20680 Removal of deep implant from bone	16	11	$1242.88	$287.66
G0413 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)	15	15	$2290.00	$807.04
72141 MRI scan of upper spinal canal	14	14	$899.00	$120.39
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	12	$332.00	$127.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
73502 X-ray of hip, 2-3 views	124	84	$158.56	$46.37
72190 X-ray of pelvis, minimum of 3 views	103	64	$168.17	$41.64
73221 Mri scan of arm joint without contrast	89	83	$820.49	$152.94
99213 Established patient office or other outpatient visit, typically 15 minutes	83	67	$240.07	$91.55
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	78	78	$387.44	$173.86
76000 Imaging guidance for procedure, 60 minutes or less	74	71	$59.46	$15.46
73552 X-ray of thigh bone, minimum 2 views	70	38	$102.57	$34.19
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	64	64	$405.50	$166.11
73560 X-ray of knee, 1-2 views	60	33	$129.07	$33.19
73721 Mri scan of leg joint without contrast	53	51	$817.21	$151.51
73610 X-ray of ankle, minimum of 3 views	50	22	$164.00	$33.62
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	41	39	$289.46	$127.12
27130 Replacement of thigh bone and hip joint with prosthesis	40	38	$2655.88	$1289.21
27279 Fusion of pelvic joint using imaging guidance	28	28	$1566.82	$734.10
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	27	27	$304.33	$130.28
72148 MRI scan of lower spinal canal	26	26	$814.77	$126.70
27245 Treatment of broken neck of thigh bone with bone implant	25	25	$2390.48	$1233.95
G0413 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)	15	15	$2094.93	$821.94
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	15	15	$2338.80	$1200.86
72141 MRI scan of upper spinal canal	14	14	$813.71	$119.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
73552 X-ray of thigh bone, minimum 2 views	124	63	$100.00	$32.07
73502 X-ray of hip, 2-3 views	117	76	$155.00	$46.33
72190 X-ray of pelvis, minimum of 3 views	107	61	$164.00	$43.00
73221 Mri scan of arm joint without contrast	104	101	$800.00	$152.56
76000 Imaging guidance for procedure, 60 minutes or less	84	79	$40.43	$14.99
72148 MRI scan of lower spinal canal	83	83	$800.00	$134.16
73721 Mri scan of leg joint without contrast	67	66	$800.00	$152.29
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	65	65	$378.00	$197.64
99213 Established patient office or other outpatient visit, typically 15 minutes	64	57	$234.00	$92.04
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	54	54	$395.00	$169.08
73610 X-ray of ankle, minimum of 3 views	49	24	$159.00	$36.68
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	44	42	$295.00	$134.67
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	41	38	$282.00	$130.01
73560 X-ray of knee, 1-2 views	38	21	$126.00	$34.94
27279 Fusion of pelvic joint using imaging guidance	32	31	$1525.00	$880.70
27245 Treatment of broken neck of thigh bone with bone implant	32	32	$2351.00	$1239.75
27130 Replacement of thigh bone and hip joint with prosthesis	25	24	$2590.00	$1293.21
72141 MRI scan of upper spinal canal	19	19	$800.00	$126.07
72146 Mri scan of middle spinal canal	19	19	$800.00	$133.14
20680 Removal of deep implant from bone	17	14	$806.00	$316.21
G0413 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)	11	11	$2038.00	$728.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
72190 X-ray of pelvis, minimum of 3 views	156	84	$163.09	$41.93
73221 Mri scan of arm joint without contrast	146	138	$802.74	$165.95
73552 X-ray of thigh bone, minimum 2 views	124	54	$100.00	$33.92
73502 X-ray of hip, 2-3 views	113	67	$155.00	$47.75
99213 Established patient office or other outpatient visit, typically 15 minutes	110	87	$234.00	$91.23
76000 Imaging guidance for procedure, 60 minutes or less	88	83	$17.00	$15.13
72148 MRI scan of lower spinal canal	83	83	$800.00	$143.77
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	75	75	$395.00	$166.94
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	74	73	$295.00	$136.40
73721 Mri scan of leg joint without contrast	66	64	$800.00	$161.97
73560 X-ray of knee, 1-2 views	55	29	$126.00	$31.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	50	43	$282.00	$132.35
73610 X-ray of ankle, minimum of 3 views	44	23	$159.00	$36.03
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	40	40	$378.00	$197.17
27245 Treatment of broken neck of thigh bone with bone implant	32	32	$2387.73	$1260.09
27279 Fusion of pelvic joint using imaging guidance	28	28	$1566.96	$986.37
73060 X-ray of upper arm, minimum of 2 views	26	11	$125.00	$31.45
27130 Replacement of thigh bone and hip joint with prosthesis	26	25	$2590.00	$1267.47
72141 MRI scan of upper spinal canal	21	21	$800.00	$132.72
27506 Open treatment of broken thigh bone	16	15	$2554.00	$1365.42
72146 Mri scan of middle spinal canal	15	15	$800.00	$141.87
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	15	15	$2284.00	$1156.61
20680 Removal of deep implant from bone	13	13	$806.00	$254.02
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	12	12	$522.00	$226.02
73562 X-ray of knee, 3 views	11	11	$161.00	$41.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
72190 X-ray of pelvis, minimum of 3 views	138	77	$162.97	$40.54
99213 Established patient office or other outpatient visit, typically 15 minutes	112	89	$234.00	$76.76
76000 Imaging guidance for procedure, 60 minutes or less	95	89	$17.00	$15.74
73552 X-ray of thigh bone, minimum 2 views	88	45	$100.00	$35.57
72170 X-ray of pelvis, 1-2 views	75	47	$157.11	$28.06
73610 X-ray of ankle, minimum of 3 views	74	30	$157.08	$35.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	71	71	$395.00	$164.04
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	68	67	$295.00	$138.80
73560 X-ray of knee, 1-2 views	66	38	$122.73	$32.80
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	60	11	$11.61	$7.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	55	51	$282.00	$109.87
73060 X-ray of upper arm, minimum of 2 views	45	12	$125.00	$31.71
73502 X-ray of hip, 2-3 views	44	33	$155.00	$44.82
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	39	39	$378.00	$206.94
27279 Fusion of pelvic joint using imaging guidance	33	33	$1409.52	$1014.48
73110 X-ray of wrist, minimum of 3 views	30	18	$125.00	$40.03
73221 Mri scan of arm joint without contrast	27	27	$800.00	$162.37
27245 Treatment of broken neck of thigh bone with bone implant	26	26	$2351.00	$1273.57
73080 X-ray of elbow, minimum of 3 views	17	12	$125.00	$31.82
27130 Replacement of thigh bone and hip joint with prosthesis	16	16	$2590.00	$1406.71
20610 Aspiration and/or injection of fluid from large joint	15	12	$469.33	$68.43
20680 Removal of deep implant from bone	14	13	$806.00	$343.03
72148 MRI scan of lower spinal canal	13	13	$800.00	$141.23
73721 Mri scan of leg joint without contrast	12	11	$800.00	$160.18
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	11	11	$2284.00	$1239.33
73562 X-ray of knee, 3 views	11	11	$161.00	$40.44
G0413 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)	11	11	$2038.00	$804.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
72170 X-ray of pelvis, 1-2 views	131	67	$152.50	$32.49
99213 Established patient office or other outpatient visit, typically 15 minutes	130	107	$234.00	$75.22
73552 X-ray of thigh bone, minimum 2 views	121	63	$95.45	$31.68
73610 X-ray of ankle, minimum of 3 views	96	37	$145.69	$31.56
76000 Imaging guidance for procedure, 60 minutes or less	89	84	$17.00	$15.72
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	72	70	$295.00	$137.08
73560 X-ray of knee, 1-2 views	59	30	$120.51	$31.65
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	58	57	$378.00	$204.23
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	53	53	$395.00	$166.32
72190 X-ray of pelvis, minimum of 3 views	51	34	$150.08	$37.62
73502 X-ray of hip, 2-3 views	48	37	$149.25	$41.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	46	42	$282.00	$110.09
27130 Replacement of thigh bone and hip joint with prosthesis	35	32	$2590.00	$1382.26
27245 Treatment of broken neck of thigh bone with bone implant	33	33	$2351.00	$1266.71
73630 X-ray of foot, minimum of 3 views	24	12	$119.50	$30.82
73110 X-ray of wrist, minimum of 3 views	22	12	$120.09	$35.95
27279 Fusion of pelvic joint using imaging guidance	19	18	$1184.84	$627.69
73562 X-ray of knee, 3 views	17	16	$161.00	$38.00
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	17	17	$2284.00	$1231.02
20680 Removal of deep implant from bone	16	16	$806.00	$303.74
20610 Aspiration and/or injection of fluid from large joint	13	12	$440.00	$55.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	147	116	$234.00	$72.85
73552 X-ray of thigh bone, minimum 2 views	135	66	$90.37	$28.61
72170 X-ray of pelvis, 1-2 views	126	69	$154.49	$31.39
73610 X-ray of ankle, minimum of 3 views	119	41	$145.87	$29.63
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	92	91	$295.00	$136.79
73560 X-ray of knee, 1-2 views	77	39	$116.18	$29.32
76000 Imaging guidance for procedure, 60 minutes or less	47	45	$17.00	$8.81
72190 X-ray of pelvis, minimum of 3 views	47	26	$142.85	$34.14
73030 X-ray of shoulder, minimum of 2 views	47	19	$151.94	$27.84
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	45	45	$378.00	$199.03
73110 X-ray of wrist, minimum of 3 views	41	22	$111.83	$32.10
73080 X-ray of elbow, minimum of 3 views	40	20	$122.30	$31.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	40	35	$282.00	$105.75
76001 Imaging guidance for procedure, more than 1 hour	40	40	$68.00	$36.37
27245 Treatment of broken neck of thigh bone with bone implant	38	38	$2397.40	$1239.44
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	36	36	$395.00	$164.74
73060 X-ray of upper arm, minimum of 2 views	34	14	$109.12	$24.81
27130 Replacement of thigh bone and hip joint with prosthesis	32	32	$2610.23	$1378.95
73502 X-ray of hip, 2-3 views	26	16	$140.85	$37.02
73630 X-ray of foot, minimum of 3 views	22	11	$114.18	$27.67
73562 X-ray of knee, 3 views	21	18	$147.48	$33.58
20680 Removal of deep implant from bone	20	18	$826.15	$272.60
27507 Treatment of broken middle of thigh bone with placement of stabilizing device	17	17	$1855.00	$784.39
G0413 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)	13	13	$2038.00	$1015.90
27279 Fusion of pelvic joint using imaging guidance	11	11	$1201.55	$507.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	182	126	$202.35	$71.98
72170 X-ray of pelvis, 1-2 views	124	65	$140.52	$31.53
73552 X-ray of thigh bone, minimum 2 views	101	48	$86.85	$31.72
73610 X-ray of ankle, minimum of 3 views	88	38	$141.75	$30.76
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	80	79	$385.43	$200.09
73560 X-ray of knee, 1-2 views	51	26	$117.53	$30.87
76001 Imaging guidance for procedure, more than 1 hour	43	40	$69.49	$35.87
73030 X-ray of shoulder, minimum of 2 views	42	23	$144.50	$29.05
27245 Treatment of broken neck of thigh bone with bone implant	39	39	$2725.97	$1204.42
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	39	39	$294.49	$134.85
76000 Imaging guidance for procedure, 60 minutes or less	38	38	$17.79	$8.64
72190 X-ray of pelvis, minimum of 3 views	37	17	$150.76	$36.49
27130 Replacement of thigh bone and hip joint with prosthesis	36	36	$3222.42	$1343.63
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	34	34	$374.62	$162.15
73110 X-ray of wrist, minimum of 3 views	34	17	$118.38	$34.45
73080 X-ray of elbow, minimum of 3 views	29	17	$125.00	$31.17
73590 X-ray of lower leg, 2 views	26	14	$109.77	$25.55
73502 X-ray of hip, 2-3 views	23	19	$145.61	$41.54
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	17	$264.95	$106.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$241.76	$106.93
73562 X-ray of knee, 3 views	17	14	$161.00	$35.82
20680 Removal of deep implant from bone	17	14	$955.71	$274.28
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	13	12	$138.46	$71.31
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	11	11	$2540.36	$1185.57
20694 Removal of external bone fixation under anesthesia	11	11	$715.09	$173.93

Medical Specialties & State Licenses

CMS Verified: 2021-04-16

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License WA MD60544517

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

1619105004 (WA)

Medicaid State Provider ID

102931509 (PA)

Hospital & Practice Group Affiliations

Kadlec Regional Medical Center

1351 Fowler St, Richland, WA 993524714

Phone: 5099461654

Kadlec Regional Medical Center

888 Swift Blvd, Richland, WA 993523514

Phone: 5099464611

Kadlec Regional Medical Center

875 Swift Blvd, Richland, WA 993523592

Phone: 5099461654

Kadlec Regional Medical Center

1135 Jadwin Ave, Richland, WA 993523434

Phone: 5099423300

Secondary Practice Locations

875 Swift Blvd

Richland, WA 993523592

Phone: 5099461654

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

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Anderson Mcgilliard

Physical Therapist

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Dr. Katherine Perry , MD

Internal Medicine - Rheumatology

NPI 1154302404

Doctor of Medicine (M.D.)

Kanpapha Baide , PT

Physical Therapist

NPI 1154753879

Physical Therapist

Dr. Jacob Stanfield , MD

Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery

NPI 1164740403

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

✅

NPI Profile Active January 27, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location January 27, 2017

Registered at 845 SWIFT BLVD, RICHLAND, WA 99352 (Tel: 5099461654)

📍

Updated Business Mailing Address January 27, 2017

Registered at 560 GAGE BLVD, SUITE 203, RICHLAND, WA 99352 (Tel: 5099423627)

👤

Provider Name / Credentials Updated January 27, 2017

Recorded as JOHN-DAVID BLACK, M.D

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 27, 2017

Orthopaedic Surgery (License #MD60544517 in WA)

✅

NPI Profile Active August 03, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location August 03, 2015

Registered at 875 SWIFT BLVD, RICHLAND, WA 993523592 (Tel: 5099461654)

📍

Updated Business Mailing Address August 03, 2015

Registered at 805 MADISON ST, SUITE 901, SEATTLE, WA 981041172

👤

Provider Name / Credentials Updated August 03, 2015

Recorded as JOHN-DAVID BLACK, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 03, 2015

Orthopaedic Surgery (License #MD60544517 in WA)

🟢

Initial NPI Registration & Enumeration June 24, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619105004

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 24, 2009

Last Update: April 16, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

560 Gage Blvd, Suite 203

Richland, WA 99352

Phone: 5099423627

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.