Healthcare Provider Details

I. General information

NPI: 1942576558
Provider Name (Legal Business Name): NORMANDIE P ENDERTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 N ASSEMBLY ST
SPOKANE WA
99205-6185
US

IV. Provider business mailing address

8810 CRESTON LN
SPOKANE WA
99208-4999
US

V. Phone/Fax

Practice location:
  • Phone: 509-434-7000
  • Fax:
Mailing address:
  • Phone: 509-701-7764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number719671
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN-37195
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN 00175324
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: