Healthcare Provider Details

I. General information

NPI: 1235164393
Provider Name (Legal Business Name): ROBERT DE LA CRUZ SANCHEZ II CRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 S COWLEY ST
SPOKANE WA
99202-1330
US

IV. Provider business mailing address

3908 E 25TH AVE
SPOKANE WA
99223-5603
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-4771
  • Fax:
Mailing address:
  • Phone: 509-536-9463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278P1005X
TaxonomyPulmonary Rehabilitation Certified Respiratory Therapist
License NumberLR00003311
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: