BACK TO LIFE LLC - BEN BOOHER DO (NPI# 1760596860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760596860 |
| Entity Type | Organization |
| Organization Name | BACK TO LIFE LLC - BEN BOOHER DO |
| Practice Address |
4309 W. 27th Pl. Suite 200 Kennewick WA 99338 |
| Mailing Address |
Po Box 53 Hermiston OR 97838-0053 |
| Practice Telephone | 5097355433 |
| Practice Fax Number | 5097355435 |
| Mailing Telephone | 5412894555 |
| Mailing Fax Number | 5412894556 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BEN W. BOOHER (PHYSICIAN) |
| Authorized Official Telephone | 541-571-8201 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | OP1774 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
4309 W. 27TH PL. SUITE 200 |
| City | KENNEWICK |
| State | WA |
| Zip Code | 99338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467974170 | Madiha Haque | Internal Medicine | Trios Care Center, 3730 Plaza, 4th Floor, Kennewick, WA 99338 | 2017-07-13 |
| 1053719864 | Christine Boynton Tano | Speech-Language Pathologist | 10411 E Vaca Rd, Kennewick, WA 99338 | 2014-12-10 |
| 1992058895 | Jennifer Kathleen Webb | Massage Therapist | 4206 W. 24th Ave. Suite A 101, Kennewick, WA 99338 | 2012-10-17 |
| 1881999639 | Tyler Rex Thornock | Nurse Anesthetist, Certified Registered | 15205 S. Mountain Ridge Ct, Kennewick, WA 99338 | 2011-01-25 |
| 1528205812 | Christina Ann Hofstetter | Massage Therapist | 4206 W. 24th Ave, Suite B103, Kennewick, WA 99338 | 2009-01-08 |
| 1619184025 | Jennifer Candice Charron | Family Medicine | 3900 S. Zintel Way, Kennewick, WA 99338 | 2007-05-16 |
| 1821211640 | Brandon P Campbell | Chiropractor | 4303 W. 27th Avenue, Suite E, Kennewick, WA 99338 | 2007-04-10 |
| 1902936206 | Stuart Lee Smithson | Chiropractor | 2411 S. Union St., Suite C, Kennewick, WA 99338 | 2007-03-06 |
| 1467580845 | Theodore J Weber Sr. | Specialist/Technologist | 3520 Southridge Blvd, Kennewick, WA 99338 | 2007-02-28 |
| 1093868572 | Canyonview Family Eye Care LLC | Optometrist | 4309 W 27th Place, Suite 102, Kennewick, WA 99338 | 2007-01-19 |
| Find all providers in zip 99338 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467974170 | Madiha Haque | Internal Medicine | Trios Care Center, 3730 Plaza, 4th Floor, Kennewick, WA 99338 | 2017-07-13 |
| 1801144050 | Angeli Duran | Internal Medicine | 216 W 10th Ave Ste 202, Kennewick, WA 99336 | 2012-08-20 |
| 1437348679 | Randy Jay Geldmacher | Internal Medicine | 602 N Colorado St., Suite D, Kadlec Clinic Gastroenterology, Kennewick, WA 99336 | 2007-10-23 |
| 1710992177 | Richland Medical Group Inc, Ps | Internal Medicine | 7233 W Deschutes Ave, Suite B, Kennewick, WA 99336 | 2006-07-31 |
| 1477596740 | John J Intravartolo Jr. | Internal Medicine | 903 S Auburn St, Kennewick, WA 99336-5662 | 2006-06-14 |
| 1063451763 | Brooks Watson II | Internal Medicine | 8220 W Gage Blvd, 750, Kennewick, WA 99336-8113 | 2006-06-06 |
| 1760443832 | Puneet Tandon | Internal Medicine | 510 N. Colorado Street, Suite A, Kadlec Clinic, Nephrology, Kennewick, WA 99336 | 2006-03-29 |
| 1467420174 | Wassim A. Khawandi | Internal Medicine | 510 N Colorado St Ste A, Kennewick, WA 99336-7845 | 2006-03-09 |
| 1740260447 | Tad Hiner | Internal Medicine | 5219 West Clearwater Ave, Suite 6, Kennewick, WA 99336 | 2006-01-19 |
| 1215921150 | Roderick Seymour Coler | Internal Medicine | 811 S Auburn St, Kennewick, WA 99336-5661 | 2005-09-07 |
| Find all providers in KENNEWICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.