Healthcare Provider Details

I. General information

NPI: 1982294187
Provider Name (Legal Business Name): KAREN A STANEK MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 11/15/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13007 E MISSION AVE
SPOKANE VALLEY WA
99216-1028
US

IV. Provider business mailing address

13007 E MISSION AVE
SPOKANE VALLEY WA
99216-1028
US

V. Phone/Fax

Practice location:
  • Phone: 509-893-3562
  • Fax:
Mailing address:
  • Phone: 509-893-3562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAREN STANEK
Title or Position: OWNER
Credential:
Phone: 509-624-0908