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Individual

JOHN W ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ARNP CNM

Contact information

Practice address
945 GOETHALS DRIVE, SUITE 200, RICHLAND, WA 99352
(509) 942-3627
(509) 942-2340
Mailing address
9605 SANDIFUR PKWY, PASCO, WA 99301-8028
(509) 942-3627
(509) 547-0827

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30003919
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9618257
WA
01
G8896839
MEDICARE
WA
Enumeration date
08/14/2006
Last updated
07/12/2012
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