Provider Demographics
NPI:1336311158
Name:ARMATROUT, JUDITH ANN
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:ARMATROUT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 W CLEARWATER AVE
Mailing Address - Street 2:SUITES A & B
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1866
Mailing Address - Country:US
Mailing Address - Phone:509-783-5127
Mailing Address - Fax:
Practice Address - Street 1:6201 W CLEARWATER AVE
Practice Address - Street 2:SUITES A & B
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1866
Practice Address - Country:US
Practice Address - Phone:509-783-5127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9047390Medicaid
WA1192390001Medicare NSC