NORTHWEST SPOKANE PEDIATRICS PLLC NPI 1952525636

NPI Information

NPI: 1952525636
Provider Name: NORTHWEST SPOKANE PEDIATRICS, PLLC

Former Legal Business Name: JOSEPH B MCMANUS MD

Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

Address:
220 E ROWAN AVE STE 150
SPOKANE, WA
ZIP 99207
Phone: (509) 483-4060
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NORTHWEST SPOKANE PEDIATRICS, PLLC is a pediatrics nurse practitioner in Spokane, WA. NORTHWEST SPOKANE PEDIATRICS, PLLC NPI is 1952525636. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Joseph B Mcmanus Md.

The provider's business location address is:

220 E ROWAN AVE STE 150
SPOKANE, WA
ZIP 99207-244
Phone: (509) 483-4060
Fax: (509) 483-0043

The provider's authorized official is Levi Jordan .
The authorized official title is Administrator and has the following contact phone number (509) 866-4646.

The CLIA number assigned to this NPI record is 50D0856695 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/12/2007 and was last updated on 9/11/2019.

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	225X00000X	Occupational Therapist				No
2	261QM1300X	Clinic/Center	Multi-Specialty			No
3	261QP2300X	Clinic/Center	Primary Care	602279511	WASHINGTON	No
4	363LP0200X	Nurse Practitioner	Pediatrics			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	1302215	MEDICAID	WASHINGTON

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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