Doctor Name: | REUBEN JAMES GROTHAUS |
NPI Number: | 1992065460 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 3950 Keene Rd Kadlec Clinic West Richland Primary Care Richland, WA - 99353 |
Business Phone Number: | 5099423130 |
Business Fax Number: | 5096288335 |
Mailing Address: | 560 Gage Blvd Ste 203, RICHLAND |
State: | WA |
Postal Code: | 99352 |
Phone Number: | 5099423627 |
Fax Number: | 5099422268 |
NPI Enumeration Date: | 05/18/2012 |
NPI Last Update Date: | 05/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |