Healthcare Provider Details

I. General information

NPI: 1871839449
Provider Name (Legal Business Name): SAMANTHA NICHOLE MAGBY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2012
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2713 N ARGONNE RD
MILLWOOD WA
99212-2239
US

IV. Provider business mailing address

400 E 5TH AVE
SPOKANE WA
99202-1334
US

V. Phone/Fax

Practice location:
  • Phone: 509-598-7860
  • Fax:
Mailing address:
  • Phone: 509-838-2931
  • Fax: 509-755-6580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number60644643
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number755968
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95000096
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number60644644
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: