Provider Demographics
NPI:1285822064
Name:REDMAN, PATRICK LEON (RDH)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:LEON
Last Name:REDMAN
Suffix:
Gender:M
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4311 SAHARA DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8146
Mailing Address - Country:US
Mailing Address - Phone:509-543-7776
Mailing Address - Fax:
Practice Address - Street 1:358 GREENBROOK PL
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-9628
Practice Address - Country:US
Practice Address - Phone:509-303-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00007392124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist