Kohler Psychiatry | |
705 Gage Blvd Ste 100 Richland WA 99352-9716 | |
(509) 518-0876 | |
(509) 987-1011 |
Full Name | Kohler Psychiatry |
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Speciality | Psychiatry & Neurology |
Location | 705 Gage Blvd Ste 100, Richland, Washington |
Authorized Official Name and Position | Justin Lee Kohler (OWNER) |
Authorized Official Contact | 5095180876 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kohler Psychiatry 705 Gage Blvd Ste 100 Richland WA 99352-9716 Ph: (509) 518-0876 | Kohler Psychiatry 705 Gage Blvd Ste 100 Richland WA 99352-9716 Ph: (509) 518-0876 |
NPI Number | 1811751092 |
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Provider Enumeration Date | 02/08/2024 |
Last Update Date | 02/16/2024 |
Certification Date | 02/16/2024 |
Medicare PECOS PAC ID | 2769829225 |
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Medicare Enrollment ID | O20240320002529 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811751092 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Justin Lee Kohler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669196994 PECOS PAC ID: 3678910130 Enrollment ID: I20240320002627 |
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