Healthcare Provider Details

I. General information

NPI: 1871288555
Provider Name (Legal Business Name): JOBE M ASHBY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 E FRONT AVE
SPOKANE WA
99202-2139
US

IV. Provider business mailing address

PO BOX 31001-4114
PASADENA CA
91110-0001
US

V. Phone/Fax

Practice location:
  • Phone: 509-626-9900
  • Fax: 509-227-7070
Mailing address:
  • Phone: 866-747-2455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.MD.70127414
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPG215468
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberPG226363
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: