Individual
GARY M PODHAISKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 ZINTEL WAY, KENNEWICK, WA 99338
(509) 942-3125
(509) 783-2167
Mailing address
3900 S ZINTEL WAY, FL 2, KENNEWICK, WA 99337-5092
(509) 942-3125
(509) 585-8173
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9069
NV
208000000X
Pediatrics Physician
Primary
MD00048590
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8493496
—
WA
Enumeration date
09/22/2006
Last updated
06/22/2021
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