Healthcare Provider Details

I. General information

NPI: 1417118399
Provider Name (Legal Business Name): CLAUDIA NADERNEJAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CLADUA FLOREZ MD

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 06/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W 8TH AVE STE 442
SPOKANE WA
99204-2361
US

IV. Provider business mailing address

1705 E 61ST AVE
SPOKANE WA
99223-8322
US

V. Phone/Fax

Practice location:
  • Phone: 509-456-6556
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number60211837
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: