Healthcare Provider Details

I. General information

NPI: 1043410194
Provider Name (Legal Business Name): NORTHWEST HEALTH SUMMIT, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16201 E INDIANA AVE SUITE 5300
SPOKANE VALLEY WA
99216-2830
US

IV. Provider business mailing address

16201 E INDIANA AVE SUITE 5300
SPOKANE VALLEY WA
99216-2830
US

V. Phone/Fax

Practice location:
  • Phone: 509-465-8885
  • Fax: 509-789-9013
Mailing address:
  • Phone: 509-465-8885
  • Fax: 509-789-9013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateWA
# 7
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number StateWA

VIII. Authorized Official

Name: CINDY S RIENDEAU
Title or Position: MANAGER
Credential:
Phone: 509-465-8885