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NPI Code Detail

MEDICARE: MARJORIE K HUMPHREY PA-C

MEDICARE: MARJORIE K HUMPHREY PA-C
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
1363AM0700XMedical Physician AssistantPA60259951WA

General Provider Information

NPI Number : 1710014303
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJORIE K HUMPHREY PA-C
Provider Business Mailing Address
First Line : 203 N WASHINGTON ST STE 300
Second Line :
City : SPOKANE
State : WA
Zip : 99201-0233
Country : US
Telephone Number : 509-444-8888
Fax Number : 509-444-7806
Provider Business Practice Location Address
First Line : 1720 2ND ST
Second Line :
City : CHENEY
State : WA
Zip : 99004-1910
Country : US
Telephone Number : 509-444-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 02/05/2016

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Directions to “ MARJORIE K HUMPHREY PA-C” Practice Location

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