Healthcare Provider Details

I. General information

NPI: 1962441899
Provider Name (Legal Business Name): PATHOLOGY SERVICES PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W 5TH AVE
SPOKANE WA
99204-2803
US

IV. Provider business mailing address

PO BOX 66500
PORTLAND OR
97290-6500
US

V. Phone/Fax

Practice location:
  • Phone: 509-473-7393
  • Fax: 509-473-7016
Mailing address:
  • Phone: 503-657-8663
  • Fax: 503-723-3180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. IRBY COSSETTE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 509-473-7393