Healthcare Provider Details

I. General information

NPI: 1104943141
Provider Name (Legal Business Name): NATHAN C DIKES DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 08/22/2020
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: DR. NATHAN CRAIG DIKES
Title or Position: OWNER
Credential: DPM
Phone: 509-928-3338