Provider Demographics
NPI:1992070346
Name:TRI-CITIES CHAPLAINCY
Entity type:Organization
Organization Name:TRI-CITIES CHAPLAINCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:WELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-783-7416
Mailing Address - Street 1:1480 FOWLER ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4717
Mailing Address - Country:US
Mailing Address - Phone:509-783-7416
Mailing Address - Fax:509-735-7850
Practice Address - Street 1:1480 FOWLER ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4717
Practice Address - Country:US
Practice Address - Phone:509-783-7416
Practice Address - Fax:509-735-7850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
WA363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty