Healthcare Provider Details

I. General information

NPI: 1245134881
Provider Name (Legal Business Name): ERWIN BORN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 S GRAND BLVD
SPOKANE WA
99202-1136
US

IV. Provider business mailing address

1303 S GRAND BLVD
SPOKANE WA
99202-1136
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-2225
  • Fax: 509-755-2225
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number70155488
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: