Healthcare Provider Details

I. General information

NPI: 1518359967
Provider Name (Legal Business Name): OSTEOARTHRITIS CENTERS OF AMERICA SPOKANE VALLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2015
Last Update Date: 08/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11915 E BROADWAY AVE STE 101
SPOKANE VALLEY WA
99206-4997
US

IV. Provider business mailing address

11915 E BROADWAY AVE STE 101
SPOKANE VALLEY WA
99206-4997
US

V. Phone/Fax

Practice location:
  • Phone: 509-228-9404
  • Fax: 509-228-9403
Mailing address:
  • Phone: 509-228-9404
  • Fax: 509-228-9403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00005023
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT00006435
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOP00002282
License Number StateWA

VIII. Authorized Official

Name: STEVEN K NEFF
Title or Position: OWNER
Credential:
Phone: 509-228-9404