Healthcare Provider Details

I. General information

NPI: 1093818890
Provider Name (Legal Business Name): NATHAN CRAIG DIKES DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10410 E 9TH AVE
SPOKANE VALLEY WA
99206-3510
US

IV. Provider business mailing address

PO BOX 141689
SPOKANE VALLEY WA
99214-1689
US

V. Phone/Fax

Practice location:
  • Phone: 509-928-3338
  • Fax: 509-232-0112
Mailing address:
  • Phone: 509-928-3338
  • Fax: 509-232-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: