Healthcare Provider Details

I. General information

NPI: 1982365581
Provider Name (Legal Business Name): FRANCISCO OQUENDO LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4305 E TRENT AVE
SPOKANE WA
99212-1315
US

IV. Provider business mailing address

4305 E TRENT AVE
SPOKANE WA
99212-1315
US

V. Phone/Fax

Practice location:
  • Phone: 509-795-3133
  • Fax:
Mailing address:
  • Phone: 509-795-3133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number00043632
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: