Organization
VISTA PAIN CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY KORENKIEWICZ (CLINIC MANAGER)
(509) 627-2848
Entity
Organization
Contact information
Practice address
8904 W TUCANNON AVE, KENNEWICK, WA 99336-7178
(509) 627-2848
(509) 627-2849
Mailing address
8904 W TUCANNON AVE, KENNEWICK, WA 99336-7178
(509) 627-2848
(509) 627-2849
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD00041323
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7142714
—
WA
Enumeration date
07/06/2010
Last updated
05/27/2021
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