Healthcare Provider Details

I. General information

NPI: 1770689465
Provider Name (Legal Business Name): VICKI A VOLZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 01/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 8TH AVE STE 4200
SPOKANE WA
99204-2307
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 509-474-2730
  • Fax: 509-462-4086
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00020010
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: