| Pure Healthcare Of Washington Llc | |
|
16201 E Indiana Ave Ste 3100 Spokane Valley WA 99216-2844 | |
| (509) 418-9880 | |
| (509) 267-3119 |
| Full Name | Pure Healthcare Of Washington Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16201 E Indiana Ave Ste 3100, Spokane Valley, Washington |
| Authorized Official Name and Position | Joshua Tandy (DIRECTOR) |
| Authorized Official Contact | 8017870731 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Healthcare Of Washington Llc 4179 S Riverboat Rd Ste 220 Taylorsville UT 84123-2986 Ph: (855) 550-3358 | Pure Healthcare Of Washington Llc 16201 E Indiana Ave Ste 3100 Spokane Valley WA 99216-2844 Ph: (509) 418-9880 |
| NPI Number | 1093487464 |
|---|---|
| Provider Enumeration Date | 10/04/2021 |
| Last Update Date | 05/25/2023 |
| Medicare PECOS PAC ID | 6204228844 |
|---|---|
| Medicare Enrollment ID | O20220112000003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093487464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Keanna Abild |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750085908 PECOS PAC ID: 8527423391 Enrollment ID: I20230501000333 |
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