MEDICARE: KATIE GROTE X

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	231H00000X	Audiologist	LD0003272	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0169264	OTHER	WA	LABOR & INDUSTRIES

General Provider Information

NPI Number	:	1952418766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE GROTE X

Provider Business Mailing Address
First Line	:	1424 N. MCDONALD ROAD
Second Line	:	SUITE 101
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-1088
Country	:	US
Telephone Number	:	509-928-1287
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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	05/03/2022

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Directions to “ KATIE GROTE X ” Practice Location

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