Healthcare Provider Details

I. General information

NPI: 1669420477
Provider Name (Legal Business Name): COLLEEN R CAREY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W 5TH AVE SUITE 102
SPOKANE WA
99204-2966
US

IV. Provider business mailing address

PO BOX 3868
SPOKANE WA
99220-3868
US

V. Phone/Fax

Practice location:
  • Phone: 509-228-1635
  • Fax: 509-252-9300
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD 00018205
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: