Healthcare Provider Details

I. General information

NPI: 1134718851
Provider Name (Legal Business Name): JAMES D SALAZAR ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2021
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE STE N
SPOKANE WA
99201-0580
US

IV. Provider business mailing address

1402 LAKE TAPPS PKWY SE STE.F104 BOX 150
AUBURN WA
98092
US

V. Phone/Fax

Practice location:
  • Phone: 206-651-5870
  • Fax:
Mailing address:
  • Phone: 360-255-1177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAP61134188
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberAP61134188
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: