Healthcare Provider Details

I. General information

NPI: 1588743009
Provider Name (Legal Business Name): VALLEY GASTROENTEROLOGY PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 E SINTO AVE
SPOKANE VALLEY WA
99216-1081
US

IV. Provider business mailing address

12401 E SINTO AVE
SPOKANE VALLEY WA
99216-1081
US

V. Phone/Fax

Practice location:
  • Phone: 509-922-2055
  • Fax: 509-922-2307
Mailing address:
  • Phone: 509-922-2055
  • Fax: 509-922-2307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL MARTIN CRAIG
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 509-922-2055