Healthcare Provider Details

I. General information

NPI: 1831263938
Provider Name (Legal Business Name): NEONATOLOGY ASSOCIATES SPOKANE PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 8TH AVE STE 336C
SPOKANE WA
99204-2302
US

IV. Provider business mailing address

105 W 8TH AVE STE 336C
SPOKANE WA
99204-2302
US

V. Phone/Fax

Practice location:
  • Phone: 509-455-8855
  • Fax: 509-455-8383
Mailing address:
  • Phone: 509-455-8855
  • Fax: 509-455-8383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. CHERYL ANN BOYD
Title or Position: ACCOUNT MANAGER
Credential:
Phone: 509-455-8855