Provider Demographics
NPI:1770310484
Name:SALGADO, ALLISON RANIERE (PA-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:RANIERE
Last Name:SALGADO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 N CENTER PKWY APT Q201
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-8237
Mailing Address - Country:US
Mailing Address - Phone:520-370-7985
Mailing Address - Fax:
Practice Address - Street 1:1295 FOWLER ST STE 102
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4736
Practice Address - Country:US
Practice Address - Phone:509-783-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA.61594227207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology