Healthcare Provider Details

I. General information

NPI: 1831580307
Provider Name (Legal Business Name): EVA SAMPLE CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EVA NEWSHAM CPM, LM

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 E EUCLID AVE
SPOKANE WA
99207-2022
US

IV. Provider business mailing address

127 E EUCLID AVE
SPOKANE WA
99207-2022
US

V. Phone/Fax

Practice location:
  • Phone: 509-326-4366
  • Fax: 509-328-9266
Mailing address:
  • Phone: 509-326-4366
  • Fax: 509-328-9266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW 60516027
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number14124R
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: