1750142543 NPI number — MR. RICARDO AMADOR RAMIREZ MHC

Table of content: MR. RICARDO AMADOR RAMIREZ MHC (NPI 1750142543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750142543 NPI number — MR. RICARDO AMADOR RAMIREZ MHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMIREZ
Provider First Name:
RICARDO
Provider Middle Name:
AMADOR
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MHC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAMIREZ
Provider Other First Name:
RICARDO
Provider Other Middle Name:
AMADOR
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MHC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1750142543
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3593 W 11TH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENNEWICK
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99338-2047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-713-9462
Provider Business Mailing Address Fax Number:
509-713-9462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3593 W 11TH PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99338-2047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-713-9462
Provider Business Practice Location Address Fax Number:
509-713-9462
Provider Enumeration Date:
01/18/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 175T00000X , with the licence number:  CG61490297 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 175T00000X , with the licence number: CG61492097 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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