Healthcare Provider Details

I. General information

NPI: 1639554330
Provider Name (Legal Business Name): JOSEPH LABRUM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16201 E INDIANA AVE STE 5300
SPOKANE VALLEY WA
99216-1882
US

IV. Provider business mailing address

16201 E INDIANA AVE STE 5300
SPOKANE VALLEY WA
99216-1882
US

V. Phone/Fax

Practice location:
  • Phone: 509-530-5420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA146995
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number61177297
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: