Healthcare Provider Details

I. General information

NPI: 1043296395
Provider Name (Legal Business Name): FRANCISCO VELAZQUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W COLLEGE AVE
SPOKANE WA
99201-2010
US

IV. Provider business mailing address

1101 W COLLEGE AVE
SPOKANE WA
99201-2010
US

V. Phone/Fax

Practice location:
  • Phone: 509-324-4199
  • Fax:
Mailing address:
  • Phone: 509-362-4199
  • Fax: 509-324-1507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number217630
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: