Healthcare Provider Details

I. General information

NPI: 1871411298
Provider Name (Legal Business Name): CALLI EDGMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16520 N DAKOTA CT
SPOKANE WA
99208-7510
US

IV. Provider business mailing address

16520 N DAKOTA CT
SPOKANE WA
99208-7510
US

V. Phone/Fax

Practice location:
  • Phone: 509-209-3601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN.RN.61041154
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: