Waller, Raymond A
Waller, Raymond A is an individual health care provider with primary practice located at 1303 16Th Ave , Clarkston WA 99403-2956. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Waller, Raymond A can be contacted via phone (509) 758-7150.Contact Information
Primary practice address
1303 16Th Ave
Clarkston WA 99403-2956
Phone: (509) 758-7150
Fax: (509) 758-8346
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / General Practice | 1223G0001X | DE00007388 | Washington |
Profile Details
NPI number | 1922176528 |
---|---|
LBN Legal business name | Waller, Raymond A |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 1st, 2006 |
Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1922176528 | NPPES |
Washington | MEDICAID | 5020086 |
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