Healthcare Provider Details

I. General information

NPI: 1124965512
Provider Name (Legal Business Name): ERIC ANZEVINO PITMAN M.S., CEP, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
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 StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: