Healthcare Provider Details

I. General information

NPI: 1336008283
Provider Name (Legal Business Name): ETHAN TURNER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 N VERCLER RD STE 1
SPOKANE VALLEY WA
99216-1092
US

IV. Provider business mailing address

1607 LINCOLN WAY
COEUR D ALENE ID
83814-2462
US

V. Phone/Fax

Practice location:
  • Phone: 509-991-7885
  • Fax:
Mailing address:
  • Phone: 208-500-0567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: