Healthcare Provider Details

I. General information

NPI: 1376598482
Provider Name (Legal Business Name): VANN EDWARD SCHAFFNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W 5TH AVE DEPARTMENT OF PATHOLOGY
SPOKANE WA
99204-2803
US

IV. Provider business mailing address

1618 E WILDFLOWER LN
SPOKANE WA
99224-8469
US

V. Phone/Fax

Practice location:
  • Phone: 509-473-7076
  • Fax: 509-473-7016
Mailing address:
  • Phone: 509-443-0340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number99-299
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD00046787
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number4827321-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: