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Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA GOMEZ MA-C AAS (OFFICE MANAGER)
(509) 221-1039
Entity
Organization

Contact information

Practice address
805 S AUBURN ST, KENNEWICK, WA 99336-5661
(509) 221-1039
(509) 221-1135
Mailing address
805 S AUBURN ST, KENNEWICK, WA 99336-5661
(509) 221-1039
(509) 221-1135

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
261QP2300X
Primary Care Clinic/Center
261QU0200X
Urgent Care Clinic/Center

Other

Enumeration date
08/08/2023
Last updated
08/08/2023
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