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NPI Code Detail

MEDICARE: DR. PAUL B HASTINGS PHD

MEDICARE: DR. PAUL B HASTINGS PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPY00000887WA

General Provider Information

NPI Number : 1124093497
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL B HASTINGS PHD
Provider Business Mailing Address
First Line : 16704 N DARTFORD DR
Second Line :
City : SPOKANE
State : WA
Zip : 99208-9771
Country : US
Telephone Number : 509-993-5463
Fax Number : 509-228-9542
Provider Business Practice Location Address
First Line : 502 E BOONE AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99258-1774
Country : US
Telephone Number : 509-465-9847
Fax Number : 509-228-9542
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 07/08/2007

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