| Providence St Lukes Rehabilitation Medical Center | |
|
711 S Cowley St Spokane WA 99202-1330 | |
| (509) 473-6000 | |
| Not Available |
| Full Name | Providence St Lukes Rehabilitation Medical Center |
|---|---|
| Speciality | Psychologist |
| Location | 711 S Cowley St, Spokane, Washington |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SEC FOR ENROLLMENT/DIR REIMB S) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence St Lukes Rehabilitation Medical Center Po Box 2185 Spokane WA 99210-2185 Ph: (509) 473-6000 | Providence St Lukes Rehabilitation Medical Center 711 S Cowley St Spokane WA 99202-1330 Ph: (509) 473-6000 |
| NPI Number | 1902497308 |
|---|---|
| Provider Enumeration Date | 01/28/2021 |
| Last Update Date | 03/17/2021 |
| Certification Date | 03/17/2021 |
| Medicare PECOS PAC ID | 9739236555 |
|---|---|
| Medicare Enrollment ID | O20210503001878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902497308 | NPI | - | NPPES |
| Provider Name | Joy R White Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881685683 PECOS PAC ID: 2668374489 Enrollment ID: I20040122000899 |
| Provider Name | Alicia F Hegie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508145731 PECOS PAC ID: 3779716519 Enrollment ID: I20170711003502 |
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