Individual
AHMED BASHIR RADDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1051 COLUMBIA AVE, CONNELL, WA 99326-8702
(509) 488-5256
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61188502
WA
Other
Enumeration date
07/10/2020
Last updated
10/02/2024
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