Provider Demographics
NPI:1508005349
Name:COLUMBIA LASER CENTERS, INC
Entity Type:Organization
Organization Name:COLUMBIA LASER CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:B
Authorized Official - Last Name:RITTENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-529-5515
Mailing Address - Street 1:714 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324-1519
Mailing Address - Country:US
Mailing Address - Phone:509-529-5515
Mailing Address - Fax:509-529-5519
Practice Address - Street 1:714 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324-1519
Practice Address - Country:US
Practice Address - Phone:509-529-5515
Practice Address - Fax:509-529-5519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044960246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty