Provider Demographics
NPI:1457531303
Name:TRI-CITY NEUROLOGY, INC.
Entity type:Organization
Organization Name:TRI-CITY NEUROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STROBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-586-5700
Mailing Address - Street 1:7211 W DESCHUTES AVE STE D201
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7715
Mailing Address - Country:US
Mailing Address - Phone:509-586-5700
Mailing Address - Fax:509-585-5945
Practice Address - Street 1:7211 W DESCHUTES AVE STE D201
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7715
Practice Address - Country:US
Practice Address - Phone:509-586-5700
Practice Address - Fax:509-585-5945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000337342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1116714Medicaid
WA8936953OtherL&I CRIME VICTIMS
WA349208400OtherFEDERAL L&I
WA130024998OtherRR MEDICARE
WA160721OtherL&I STATE
WA349208400OtherFEDERAL L&I