MEDICARE: SPOKANE VALLEY EAR, NOSE &THROAT, P.S.

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	59650	OTHER	WA	LABOR & INDUSTRIES
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8919358	OTHER	WA	CRIME VICTIMS PROVIDER #
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861506289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPOKANE VALLEY EAR, NOSE &THROAT, P.S.

Provider Business Mailing Address
First Line	:	1424 N. MCDONALD RD
Second Line	:	SUITE 101
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-1088
Country	:	US
Telephone Number	:	509-928-7272
Fax Number	:	509-928-7346

Provider Business Practice Location Address
First Line	:	1424 N MCDONALD RD STE 101
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-6017
Country	:	US
Telephone Number	:	509-928-7272
Fax Number	:	509-928-7346

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ERIC BRYAN LEAVITT
Credential	:	M.D.
Telephone Number	:	509-928-7272

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	05/03/2022

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Directions to “SPOKANE VALLEY EAR, NOSE &THROAT, P.S. ” Practice Location

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