Healthcare Provider Details

I. General information

NPI: 1245673151
Provider Name (Legal Business Name): JOSHUA JUDD FITE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13103 E MANSFIELD AVE
SPOKANE VALLEY WA
99216-1642
US

IV. Provider business mailing address

PO BOX 3405
SPOKANE WA
99220-3405
US

V. Phone/Fax

Practice location:
  • Phone: 509-892-2700
  • Fax: 509-892-2740
Mailing address:
  • Phone: 509-892-2700
  • Fax: 509-892-2740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD84947
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD60944990
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: