Healthcare Provider Details

I. General information

NPI: 1285769141
Provider Name (Legal Business Name): TAMOSS IKEI CARNES MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N HOWARD ST STE W
SPOKANE WA
99201-0508
US

IV. Provider business mailing address

100 N HOWARD ST STE W
SPOKANE WA
99201-0508
US

V. Phone/Fax

Practice location:
  • Phone: 424-419-7858
  • Fax:
Mailing address:
  • Phone: 424-419-7858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC61662004
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: