| Providence Medical Group Doctors Building | |
|
105 W 8th Ave Suite 7040 Spokane WA 99204-2302 | |
| (509) 456-2406 | |
| (509) 456-2407 |
| Full Name | Providence Medical Group Doctors Building |
|---|---|
| Speciality | Family Medicine |
| Location | 105 W 8th Ave, Spokane, Washington |
| Authorized Official Name and Position | Katlyn L Lee (CREDENTIALING & ONBOARDING SPECIALI) |
| Authorized Official Contact | 5094742072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Doctors Building Po Box 34439 Seattle WA 98124-1439 Ph: (509) 474-2072 | Providence Medical Group Doctors Building 105 W 8th Ave Suite 7040 Spokane WA 99204-2302 Ph: (509) 456-2406 |
| NPI Number | 1023385721 |
|---|---|
| Provider Enumeration Date | 11/23/2011 |
| Last Update Date | 11/23/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023385721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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