Healthcare Provider Details

I. General information

NPI: 1619969557
Provider Name (Legal Business Name): RICHARD G GOWER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 W 7TH AVE
SPOKANE WA
99204-2850
US

IV. Provider business mailing address

823 W 7TH AVE
SPOKANE WA
99204-2850
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-3655
  • Fax: 509-838-1952
Mailing address:
  • Phone: 509-838-3655
  • Fax: 509-838-1952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD00015760
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: