Healthcare Provider Details

I. General information

NPI: 1528735917
Provider Name (Legal Business Name): MICHAEL KOS MD, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 04/22/2022
Certification Date: 04/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13424 E MISSION AVE # A
SPOKANE VALLEY WA
99216-2759
US

IV. Provider business mailing address

6506 S REGAL CT
SPOKANE WA
99223-2117
US

V. Phone/Fax

Practice location:
  • Phone: 509-321-4980
  • Fax: 530-576-0364
Mailing address:
  • Phone: 775-560-5776
  • Fax: 530-576-0364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY S CATTANEO
Title or Position: MANAGER
Credential:
Phone: 530-955-5983