Healthcare Provider Details

I. General information

NPI: 1174905376
Provider Name (Legal Business Name): MARY E BACHKO, ARNP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9803 E SPRAGUE AVE
SPOKANE VALLEY WA
99206-3645
US

IV. Provider business mailing address

9803 E SPRAGUE AVE
SPOKANE VALLEY WA
99206-3645
US

V. Phone/Fax

Practice location:
  • Phone: 509-342-7411
  • Fax: 509-342-7413
Mailing address:
  • Phone: 509-342-7411
  • Fax: 509-342-7413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY E BACHKO
Title or Position: OWNER/PROVIDER
Credential: ARNP
Phone: 509-342-7411