Provider Demographics
NPI:1093925794
Name:NAJERA, TRAVIS ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:ALEXANDER
Last Name:NAJERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TRAVIS
Other - Middle Name:
Other - Last Name:NAJERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1620 N ROAD 44
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-2667
Mailing Address - Country:US
Mailing Address - Phone:509-396-3001
Mailing Address - Fax:509-544-2158
Practice Address - Street 1:1620 N ROAD 44
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-2667
Practice Address - Country:US
Practice Address - Phone:509-396-3001
Practice Address - Fax:509-544-2158
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.011752207Q00000X
WAMD60079458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine