Healthcare Provider Details

I. General information

NPI: 1275588147
Provider Name (Legal Business Name): SLEEP INSTITUTE OF SPOKANE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 S SHERMAN ST STE 6
SPOKANE WA
99202-1461
US

IV. Provider business mailing address

324 S SHERMAN ST BLDG A
SPOKANE WA
99202-1461
US

V. Phone/Fax

Practice location:
  • Phone: 509-353-3960
  • Fax: 509-343-0134
Mailing address:
  • Phone: 509-353-3960
  • Fax: 509-343-0134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number602 094 452
License Number StateWA

VIII. Authorized Official

Name: JEFFREY C ELMER
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 509-353-3960