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1326005851

NPI Code Detail

MEDICARE: COMMUNITY HEALTH ASSOCIATION OF SPOKANE

MEDICARE: COMMUNITY HEALTH ASSOCIATION OF SPOKANE

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	261QF0400X	Federally Qualified Health Center (FQHC)

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DA6658	OTHER		MEDICARE PALMETTO RAIL RD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	107498	OTHER	WA	L & I GROUP #
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326005851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH ASSOCIATION OF SPOKANE

Provider Business Mailing Address
First Line	:	611 N IRON BRIDGE WAY
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99202-4932
Country	:	US
Telephone Number	:	509-444-8888
Fax Number	:	509-444-8706

Provider Business Practice Location Address
First Line	:	3919 N MAPLE ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-1349
Country	:	US
Telephone Number	:	509-444-8888
Fax Number	:	509-444-8706

Authorized Official
Title or Position	:	CEO
Name	:	AARON WILSON
Credential	:
Telephone Number	:	509-444-8888

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	10/18/2021

Similar Medicare Providers

1417810268 — TAYLOR THOMPSON
Practice Location Address:

3919 N MAPLE ST
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99205-1349

Practice Phone: 509-444-8200
Practice Fax:

1821739798 — SERA ANN JACOB DO
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1639442551 — LINDSEY LEE THOMPSON PHARMD
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1619932696 — DANIEL R. MOORMAN M.D.
Practice Location Address:

3919 N MAPLE ST
SPOKANE, WA
99205-1349

Practice Phone: 509-444-8200
Practice Fax: 509-444-7806

1265490247 — ETHAN M ANGELL MD
Practice Location Address:

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SPOKANE, WA
99205-1349

Practice Phone: 509-444-7801
Practice Fax: 509-444-7807

1396703377 — DAVID H BARE
Practice Location Address:

3919 N MAPLE ST
SPOKANE, WA
99205-1349

Practice Phone: 509-444-8888
Practice Fax: 509-444-7806

Directions to “COMMUNITY HEALTH ASSOCIATION OF SPOKANE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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