Healthcare Provider Details

I. General information

NPI: 1578797791
Provider Name (Legal Business Name): WOMEN'S HEALTH CONNECTION AMBULATORY SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 05/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9425 N NEVADA ST SUITE 300
SPOKANE WA
99218-5014
US

IV. Provider business mailing address

9425 N NEVADA ST SUITE 300
SPOKANE WA
99218-5014
US

V. Phone/Fax

Practice location:
  • Phone: 509-465-8885
  • Fax: 509-789-9013
Mailing address:
  • Phone: 509-465-8885
  • Fax: 509-789-9013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number602552714
License Number StateWA

VIII. Authorized Official

Name: JENIFER FRANKLIN
Title or Position: BILLING/CREDENTIALING
Credential:
Phone: 509-465-8885