Provider Demographics
NPI:1700969391
Name:GILL, RITCHIE, WALKER PLLC
Entity Type:Organization
Organization Name:GILL, RITCHIE, WALKER PLLC
Other - Org Name:ORCHARD HILLS PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE MANAGER
Authorized Official - Phone:509-375-5000
Mailing Address - Street 1:705 GAGE BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352
Mailing Address - Country:US
Mailing Address - Phone:509-375-5000
Mailing Address - Fax:509-420-4247
Practice Address - Street 1:705 GAGE BLVD
Practice Address - Street 2:STE 300
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-375-5000
Practice Address - Fax:509-420-4247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1223P0221X, 261QD0000X
WA50C0001212261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7131238Medicaid
50C0001212OtherMEDICARE GROUP #
WA5036876Medicaid
AB32234Medicare UPIN
WAAB32234Medicare ID - Type UnspecifiedASC GROUP