Healthcare Provider Details

I. General information

NPI: 1538666938
Provider Name (Legal Business Name): MICHAEL J FINCH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 NW GOLDEN HILLS SPC #21
PULLMAN WA
99163-9916
US

IV. Provider business mailing address

255 NW GOLDEN HILLS DR SPC 21
PULLMAN WA
99163-8980
US

V. Phone/Fax

Practice location:
  • Phone: 509-335-5485
  • Fax:
Mailing address:
  • Phone: 509-332-9488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: