Healthcare Provider Details

I. General information

NPI: 1386684470
Provider Name (Legal Business Name): LINDA VARRELLA MUIR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 8TH AVE
SPOKANE WA
99204-2302
US

IV. Provider business mailing address

910 N WASHINGTON ST STE 209
SPOKANE WA
99201-2202
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-5445
  • Fax: 509-474-2241
Mailing address:
  • Phone: 509-232-1145
  • Fax: 509-232-1165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00043967
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberMD00043967
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: