MEDICARE: DONALD F. CONDON M.D.

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
1	207Q00000X	Family Medicine Physician	MD00016998	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134128697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD F. CONDON M.D.

Provider Business Mailing Address
First Line	:	9631 N NEVADA ST
Second Line	:	SUITE 202
City	:	SPOKANE
State	:	WA
Zip	:	99218-1133
Country	:	US
Telephone Number	:	509-467-1100
Fax Number	:	509-468-0173

Provider Business Practice Location Address
First Line	:	9631 N NEVADA ST
Second Line	:	SUITE 202
City	:	SPOKANE
State	:	WA
Zip	:	99218-1133
Country	:	US
Telephone Number	:	509-467-1100
Fax Number	:	509-468-0173

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	11/22/2019

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Directions to “ DONALD F. CONDON M.D.” Practice Location

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