DACOTAH J SPURGEON MS PT PA-C NPI 1902975097

NPI Information

NPI: 1902975097
Provider Name: DACOTAH J SPURGEON, MS PT, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1114 W 20TH AVE
SPOKANE, WA
ZIP 99203
Phone: (509) 230-3745
Get Directions

Dacotah J Spurgeon, MS PT, PA-C is a medical physician assistant in Spokane, WA with 5 years of experience. Dacotah J Spurgeon, MS PT, PA-C NPI is 1902975097. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduation Year:2019

The provider's business location address is:

1114 W 20TH AVE
SPOKANE, WA
ZIP 99203-147
Phone: (509) 230-3745

The NPI 1902975097 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/6/2006 and was last updated on 9/13/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225100000X	Physical Therapist		PT00009166	WASHINGTON	No
2	363AM0700X	Physician Assistant	Medical			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8362733	MEDICAID	WASHINGTON
2	172561	OTHER	WASHINGTON	LABOR AND INDUSTRY /L&I/ WASHINGTON STATE

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

NPI Synchronization or Removal

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