Organization
NEUROPSYCH PROGRAM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KISHORE S H M VARADA PA-C (CHAIRMAN/CEO)
(509) 539-4273
Entity
Organization
Contact information
Practice address
1446 SPAULDING PARK STE 303, RICHLAND, WA 99352-4720
(509) 420-5060
(509) 420-5059
Mailing address
1446 SPAULDING PARK STE 303, RICHLAND, WA 99352-4720
(509) 420-5060
(509) 420-5059
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
MD 00038813
WA
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
MD 00038336
WA
363AM0700X
Medical Physician Assistant
PA 10005331
WA
Other
Enumeration date
12/31/2012
Last updated
12/31/2012
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