Healthcare Provider Details

I. General information

NPI: 1639263742
Provider Name (Legal Business Name): VETERANS ADMINISTRATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 N ASSEMBLY ST VETERANS AFFAIRS MEDICAL CENTER
SPOKANE WA
99205-6185
US

IV. Provider business mailing address

4815 N ASSEMBLY ST VETERANS AFFAIRS MEDICAL CENTER
SPOKANE WA
99205-6185
US

V. Phone/Fax

Practice location:
  • Phone: 509-434-7010
  • Fax:
Mailing address:
  • Phone: 509-434-7010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM FREDERICK NELSON
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 509-434-7010