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NPI Code Detail

MEDICARE: JOSHUA THERRIEN

MEDICARE:   JOSHUA  THERRIEN
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
12255A2300XAthletic TrainerA1 60704325WA

General Provider Information

NPI Number : 1356883748
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA THERRIEN
Provider Business Mailing Address
First Line : 5121 W OXFORD AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99208-6724
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 502 E BOONE AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99258-1774
Country : US
Telephone Number : 509-432-6598
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2016
Last Update Date : 11/16/2016

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Directions to “ JOSHUA THERRIEN ” Practice Location

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