Individual
OVIDIO BUSCAINO DEMIAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
700 S 11TH ST, SUNNYSIDE, WA 98944-2243
(509) 839-6288
(509) 839-5913
Mailing address
PO BOX 957, SUNNYSIDE, WA 98944-0957
(509) 839-6822
(509) 839-5913
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10001114
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166737
LABOR & INDUSTRIES
WA
01
—
G115140700
MEDICARE ID-PIN
WA
01
—
PA10001114
STATE LICENSE
WA
Enumeration date
01/04/2007
Last updated
03/07/2023
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