Provider Demographics
NPI:1588987291
Name:BI-STATE OCCUPATIONAL SAFETY & HEALTH
Entity type:Organization
Organization Name:BI-STATE OCCUPATIONAL SAFETY & HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARABBA
Authorized Official - Suffix:
Authorized Official - Credentials:PAC
Authorized Official - Phone:509-783-8100
Mailing Address - Street 1:4303 W 27TH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-1986
Mailing Address - Country:US
Mailing Address - Phone:509-783-8100
Mailing Address - Fax:509-783-8104
Practice Address - Street 1:4303 W 27TH AVE STE D
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-1986
Practice Address - Country:US
Practice Address - Phone:509-783-8100
Practice Address - Fax:509-783-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6020922202083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1861656902OtherNPI
WA7360UNOtherBLUE SHIELD
WA1447343967OtherNPI
WA176451OtherWA LABOR & IINDUSTRIES IME
WA1861656902OtherNPI
WA7360UNOtherBLUE SHIELD