Healthcare Provider Details

I. General information

NPI: 1386473999
Provider Name (Legal Business Name): JESSICA DARNEY LCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 S WASHINGTON ST
SPOKANE WA
99204-2620
US

IV. Provider business mailing address

514 S WASHINGTON ST
SPOKANE WA
99204-2620
US

V. Phone/Fax

Practice location:
  • Phone: 509-624-3314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberOI61573037
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: