Organization
DISRUPTION HEALTHCARE PLLC
Active
Organization
DISRUPTION HEALTHCARE PLLC
Active
Other names
Complex Care Center PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH GAYTAN (REVENUE CYCLE MANAGER)
(509) 713-1315
Entity
Organization
Contact information
Practice address
969 STEVENS DR STE 3A, RICHLAND, WA 99352-3558
(509) 713-1315
Mailing address
969 STEVENS DR STE 3A, RICHLAND, WA 99352-3558
(509) 713-1315
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/19/2023
Last updated
04/16/2026
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