MEDICARE: RUTH ANN OMAN ARNP

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	163W00000X	Registered Nurse	RN00103657	WA
2	363LF0000X	Family Nurse Practitioner	AP60147816	WA

General Provider Information

NPI Number	:	1689864159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH ANN OMAN ARNP

Provider Business Mailing Address
First Line	:	2908 E CLEVELAND AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99207-5558
Country	:	US
Telephone Number	:	509-251-4739
Fax Number	:

Provider Business Practice Location Address
First Line	:	S 2320 SALNAVE RD
Second Line	:
City	:	MEDICAL LAKE
State	:	WA
Zip	:	99022-0200
Country	:	US
Telephone Number	:	509-299-1978
Fax Number	:

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

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	07/14/2021

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