Healthcare Provider Details

I. General information

NPI: 1336379015
Provider Name (Legal Business Name): NORTHEAST WASHINGTON HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N ARGONNE RD BLDG C
SPOKANE VALLEY WA
99212-2876
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 509-747-2462
  • Fax: 509-747-2173
Mailing address:
  • Phone: 337-233-1307
  • Fax: 337-233-5764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA L PROFFITT
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307