Healthcare Provider Details

I. General information

NPI: 1013890219
Provider Name (Legal Business Name): BETHANY FAWN HALLOWELL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W 5TH AVE
SPOKANE WA
99204-2966
US

IV. Provider business mailing address

7505 E COLUMBIA DR
SPOKANE WA
99212-1618
US

V. Phone/Fax

Practice location:
  • Phone: 509-755-5500
  • Fax: 509-744-1741
Mailing address:
  • Phone: 509-240-3288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60559603
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number70042791
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: