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PROVIDENCE PHSYICIAN SERVICES NPI 1952687386


NPI Information

NPI: 1952687386
Provider Name: PROVIDENCE PHSYICIAN SERVICES

Doing Business As: PROVIDENCE FAMILY MEDICINE MANITO CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 50D0674902

Address:
1919 S. GRAND BLVD.
SPOKANE, WA
ZIP 99203
Phone: (509) 789-9925
Get Directions

PROVIDENCE PHSYICIAN SERVICES is a family medicine in Spokane, WA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROVIDENCE PHSYICIAN SERVICES NPI is 1952687386. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence Family Medicine Manito Clinic.

The provider's business location address is:

1919 S. GRAND BLVD.
SPOKANE, WA
ZIP 99203
Phone: (509) 789-9925

The provider's authorized official is Michael Mallory .
The authorized official title is Cred. Specialist and has the following contact phone number (425) 525-6798.

The CLIA number assigned to this NPI record is 50D0674902 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2011 and was last updated on 10/31/2011.


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
1207Q00000XFamily MedicineYes

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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