Basic Information
Provider Information
NPI: 1922440379
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FROH
FirstName: MICHELLE
MiddleName: RENEE
NamePrefix: MS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 550 GAGE BLVD STE 101
Address2:  
City: RICHLAND
State: WA
PostalCode: 993529532
CountryCode: US
TelephoneNumber: 5099423627
FaxNumber: 5096272983
Practice Location
Address1: 7360 W. DESCHUTES AVE
Address2: COLUMBIA BASIN HEMATOLOGY AND ONCOLOGY
City: KENNEWICK
State: WA
PostalCode: 99336
CountryCode: US
TelephoneNumber: 5097830144
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/26/2013
LastUpdateDate: 05/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP60401096WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000XAP60401096WAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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