Healthcare Provider Details

I. General information

NPI: 1164841136
Provider Name (Legal Business Name): JAY WOJCIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12410 E SINTO AVE STE 201
SPOKANE VALLEY WA
99216-2280
US

IV. Provider business mailing address

12410 E SINTO AVE STE 201
SPOKANE VALLEY WA
99216-2280
US

V. Phone/Fax

Practice location:
  • Phone: 509-343-3854
  • Fax:
Mailing address:
  • Phone: 509-343-3854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME139157
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD2020-0582
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD61401603
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: