Individual
DR. JOHN J INTRAVARTOLO JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
903 S AUBURN ST, KENNEWICK, WA 99336-5662
(509) 582-8225
(509) 582-2893
Mailing address
903 S AUBURN ST, KENNEWICK, WA 99336-5662
(509) 582-8225
(509) 582-2893
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00012630
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1120450
—
WA
Enumeration date
06/14/2006
Last updated
07/08/2007
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