Healthcare Provider Details

I. General information

NPI: 1073440921
Provider Name (Legal Business Name): INLAND NORTHWEST EXERCISE PHYSIOLOGY AND WEIGHT MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2107 N HOUK RD APT 8
SPOKANE VALLEY WA
99216-2702
US

IV. Provider business mailing address

2107 N HOUK RD APT 8
SPOKANE VALLEY WA
99216-2702
US

V. Phone/Fax

Practice location:
  • Phone: 571-214-5833
  • Fax:
Mailing address:
  • Phone: 571-214-5833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State

VIII. Authorized Official

Name: ERIC ANZEVINO PITMAN
Title or Position: OWNER/MANAGER
Credential: MS, ACSM-CEP
Phone: 571-214-5833