| Prevention Nw | |
|
17110 E Daybreak Ln Spokane Valley WA 99016-8767 | |
| (509) 475-1347 | |
| Not Available |
| Full Name | Prevention Nw |
|---|---|
| Speciality | Clinic/Center |
| Location | 17110 E Daybreak Ln, Spokane Valley, Washington |
| Authorized Official Name and Position | Jill Harvey (OWNER/PHARMACIST) |
| Authorized Official Contact | 5094751347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prevention Nw 17110 E Daybreak Ln Spokane Valley WA 99016-8767 Ph: (509) 475-1347 | Prevention Nw 17110 E Daybreak Ln Spokane Valley WA 99016-8767 Ph: (509) 475-1347 |
| NPI Number | 1629666029 |
|---|---|
| Provider Enumeration Date | 01/02/2021 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 0143633305 |
|---|---|
| Medicare Enrollment ID | O20230222000365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629666029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Michael Dewayne Cronquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578806097 PECOS PAC ID: 3678814746 Enrollment ID: I20190418001171 |
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