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ROTH MEDICAL CLINIC LLC NPI 1861783847


NPI Information

NPI: 1861783847
Provider Name: ROTH MEDICAL CLINIC, LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 50D0975316

Address:
220 E ROWAN AVE STE 200
SPOKANE, WA
ZIP 99207
Phone: (509) 483-4403
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ROTH MEDICAL CLINIC, LLC is a clinic center in Spokane, WA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ROTH MEDICAL CLINIC, LLC NPI is 1861783847. The provider is registered as an organization entity type.

The provider's business location address is:

220 E ROWAN AVE STE 200
SPOKANE, WA
ZIP 99207-203
Phone: (509) 483-4403
Fax: (509) 489-7556

The provider's authorized official is William Terrence Roth .
The authorized official title is Owner and has the following contact phone number (509) 483-4403.

The CLIA number assigned to this NPI record is 50D0975316 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/26/2011 and was last updated on 4/26/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterMD 00035230WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G52107MEDICARE UPINWASHINGTON
21111145MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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