Provider Demographics
NPI:1164851069
Name:TRINIDAD, DAVID RALPH (ARNP-C)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RALPH
Last Name:TRINIDAD
Suffix:
Gender:M
Credentials:ARNP-C
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Mailing Address - Street 1:560 GAGE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-942-2268
Practice Address - Street 1:888 SWIFT BLVD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-946-4611
Practice Address - Fax:509-942-2185
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2017-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60721654363LA2100X
AZAP5125363LA2100X
NMCNP-02291363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1164851069Medicaid