| Full Name | |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 101 W 8th Ave, Spokane, Washington |
| Authorized Official Name and Position | Donald Wayne Anderson (ASSISTANT SECRETARY FOR ENROLLMENT) |
| Authorized Official Contact | 4253589786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 31001-4110 Pasadena CA 91110-4110 Ph: (509) 474-3131 | 101 W 8th Ave Spokane WA 99204 Ph: (509) 474-3131 |
| NPI Number | 1144471715 |
|---|---|
| Provider Enumeration Date | 10/01/2008 |
| Last Update Date | 01/10/2025 |
| Certification Date | 01/02/2025 |
| Medicare PECOS PAC ID | 5799845830 |
|---|---|
| Medicare Enrollment ID | O20081119000863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144471715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | HAC.FS.00000162 (Washington) | Secondary |
| 282N00000X | General Acute Care Hospital | (Washington) | Primary |
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