Healthcare Provider Details

I. General information

NPI: 1871625855
Provider Name (Legal Business Name): JUDY FELGENHAUER, M.D., P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 8TH AVE PEDIARTIC ONCOLOGY CLINIC
SPOKANE WA
99204-2307
US

IV. Provider business mailing address

PO BOX 8066
SPOKANE WA
99203-0066
US

V. Phone/Fax

Practice location:
  • Phone: 509-456-0882
  • Fax: 509-455-9948
Mailing address:
  • Phone: 509-456-0882
  • Fax: 509-455-9948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DENIS G FELGENHAUER
Title or Position: TREASURER
Credential: MBA, CPAM
Phone: 509-456-0882