Healthcare Provider Details

I. General information

NPI: 1003498510
Provider Name (Legal Business Name): PETER LAWRENCE LOEFFLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 W 6TH AVE
SPOKANE WA
99204-3582
US

IV. Provider business mailing address

1522 WESTERN AVE STE 24232
SEATTLE WA
98101-1522
US

V. Phone/Fax

Practice location:
  • Phone: 509-245-4068
  • Fax:
Mailing address:
  • Phone: 509-263-8792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD61472272
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: