Healthcare Provider Details

I. General information

NPI: 1386911832
Provider Name (Legal Business Name): PREMIER CLINICAL RESEARCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2011
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W 5TH AVE 320W
SPOKANE WA
99204-4880
US

IV. Provider business mailing address

104 W 5TH AVE 320W
SPOKANE WA
99204-4880
US

V. Phone/Fax

Practice location:
  • Phone: 509-343-3710
  • Fax: 509-242-1799
Mailing address:
  • Phone: 509-343-3710
  • Fax: 509-242-1799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. DALYN M BOEHM
Title or Position: DIRECTOR OF RESEARCH/ CO OWNER
Credential: BS
Phone: 509-879-6887