Healthcare Provider Details

I. General information

NPI: 1720394521
Provider Name (Legal Business Name): JOSHUA ELLIS DRUMM D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E CENTRAL AVE STE 245
SPOKANE WA
99208
US

IV. Provider business mailing address

PO BOX 421
LIBERTY LAKE WA
99019-0421
US

V. Phone/Fax

Practice location:
  • Phone: 509-252-1977
  • Fax: 509-227-7070
Mailing address:
  • Phone: 509-252-1977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOP60349600
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: