Healthcare Provider Details

I. General information

NPI: 1043657422
Provider Name (Legal Business Name): MICHALINA KUPSIK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2013
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S SHERMAN ST
SPOKANE WA
99202-1311
US

IV. Provider business mailing address

1204 N VERCLER RD
SPOKANE VALLEY WA
99216-1020
US

V. Phone/Fax

Practice location:
  • Phone: 509-228-1000
  • Fax: 509-252-9300
Mailing address:
  • Phone: 509-228-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD61494369
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number6771249
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberKUPSIM153QE
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD61494369
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: