Individual
LUAY D AILABOUNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 GOETHALS DRIVE, 2ND FLOOR, KADLEC CLINIC GENERAL & COLORECTAL SURGERY, RICHLAND, WA 99352-3304
(509) 942-3185
(509) 946-1850
Mailing address
560 GAGE BLVD, SUITE 203, RICHLAND, WA 99352-8650
(509) 942-3627
(509) 942-2268
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD60323856
WA
208C00000X
Colon & Rectal Surgery Physician
Primary
MD30623856
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0310710
L&I
WA
05
—
1114186459
—
WA
05
—
500655571
—
OR
Enumeration date
06/02/2008
Last updated
04/05/2021
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