Healthcare Provider Details

I. General information

NPI: 1528284783
Provider Name (Legal Business Name): FRANK M ROSEKRANS III
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 W SINTO
SPOKANE WA
99201-2428
US

IV. Provider business mailing address

530 W SINTO
SPOKANE WA
99201-2428
US

V. Phone/Fax

Practice location:
  • Phone: 509-326-3804
  • Fax: 509-326-3805
Mailing address:
  • Phone: 509-326-3804
  • Fax: 509-326-3805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number591
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number591
License Number StateWA

VIII. Authorized Official

Name: DR. FRANK M. ROSEKRANS III
Title or Position: OWNER
Credential:
Phone: 509-326-3804