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Individual

ROMAN R GAVINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7211 W DESCHUTES AVE, KENNEWICK, WA 99336-7728
(509) 737-1880
(509) 737-1879
Mailing address
7211 W DESCHUTES AVE, SUITE E, KENNEWICK, WA 99336-7728
(509) 735-9239
(509) 735-9310

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
052175
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000975939A
GA
05
000975939B
GA
05
1922075597
WA
Enumeration date
03/02/2006
Last updated
12/08/2011
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