Healthcare Provider Details

I. General information

NPI: 1801963947
Provider Name (Legal Business Name): GRIGGSBY H. WRIGHT IV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7115 N DIVISION ST B-173
SPOKANE WA
99208-6507
US

IV. Provider business mailing address

7115 N DIVISION ST B-173
SPOKANE WA
99208-6507
US

V. Phone/Fax

Practice location:
  • Phone: --1
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberLL29501
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberL1154431
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD60050882
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD60050882
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License NumberMD60050882
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code209800000X
TaxonomyLegal Medicine (M.D./D.O.) Physician
License NumberMD60050882
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: