Healthcare Provider Details
I. General information
NPI: 1164799896
Provider Name (Legal Business Name): MEDICINE NATURALLY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/23/2011
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2607 S SOUTHEAST BLVD B214
SPOKANE WA
99223-4942
US
IV. Provider business mailing address
6931 N DOUGLASS ST
SPOKANE WA
99208-3766
US
V. Phone/Fax
- Phone: 509-230-5043
- Fax:
- Phone: 509-230-5043
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD00041932 |
| License Number State | WA |
VIII. Authorized Official
Name:
MONICA
GERMANY
Title or Position: OWNER
Credential: MD
Phone: 509-230-5043