Individual
MR. RICHARD L WITHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6703 W RIO GRANDE AVE, KENNEWICK, WA 99336-2623
(509) 460-5588
(509) 783-5438
Mailing address
6703 W RIO GRANDE AVE, KENNEWICK, WA 99336-2623
(509) 460-5588
(509) 783-5438
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
PA60460660
WA
363A00000X
Physician Assistant
Primary
PA60460660
WA
363AS0400X
Surgical Physician Assistant
PA60460660
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2036046
—
WA
01
—
331850
LABOR & INDUSTRIES
WA
01
—
P01547455
RR MEDICARE
WA
Enumeration date
11/01/2010
Last updated
08/02/2019
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