Healthcare Provider Details

I. General information

NPI: 1962504738
Provider Name (Legal Business Name): VETERAN ADMINISTRATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 N ASSEMBLY ST
SPOKANE WA
99205-6185
US

IV. Provider business mailing address

3230 E COURTLAND AVE
SPOKANE WA
99217-6902
US

V. Phone/Fax

Practice location:
  • Phone: 509-434-7777
  • Fax:
Mailing address:
  • Phone: 509-484-3214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number StateWA

VIII. Authorized Official

Name: MR. ANTHONY NMN BRADLEY
Title or Position: SOCIAL WORKER
Credential: MSW
Phone: 509-434-7777