Individual
ETHAN ALLEN BACHRACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
888 SWIFT BLVD, RICHLAND, WA 99352-3514
(509) 946-4611
(509) 942-2757
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00044707
WA
207P00000X
Emergency Medicine Physician
MD27306
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202675
LIWA
WA
01
—
0216266
LIWA
WA
01
—
0227894
LIWA
WA
01
—
041428016
BSOR
OR
05
—
247610
—
OR
01
—
3075BA
BSWA
WA
01
—
3079BA
BSWA
WA
05
—
8077014
—
ID
05
—
8429581
—
WA
Enumeration date
05/25/2006
Last updated
10/26/2010
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