Healthcare Provider Details

I. General information

NPI: 1295084242
Provider Name (Legal Business Name): AIDAN C CLINE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16528 E DESMET CT STE A1600
SPOKANE VALLEY WA
99216-3522
US

IV. Provider business mailing address

16528 E DESMET CT STE A1600
SPOKANE VALLEY WA
99216-3522
US

V. Phone/Fax

Practice location:
  • Phone: 509-944-8907
  • Fax:
Mailing address:
  • Phone: 509-944-8907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA70047097
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: