Healthcare Provider Details

I. General information

NPI: 1366141434
Provider Name (Legal Business Name): SAMANTHA PATTERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 02/28/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 8TH AVE
SPOKANE WA
99204-2307
US

IV. Provider business mailing address

324 E 28TH AVE
SPOKANE WA
99203-2504
US

V. Phone/Fax

Practice location:
  • Phone: 509-464-3131
  • Fax:
Mailing address:
  • Phone: 509-294-4027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN61132199
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: