Healthcare Provider Details

I. General information

NPI: 1619446002
Provider Name (Legal Business Name): COMMUNITY HEALTH ASSOCIATION OF SPOKANE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 W CARLISLE AVE
SPOKANE WA
99205-3309
US

IV. Provider business mailing address

611 N IRON BRIDGE WAY
SPOKANE WA
99202-4932
US

V. Phone/Fax

Practice location:
  • Phone: 509-340-1565
  • Fax: 509-326-5225
Mailing address:
  • Phone: 509-444-8888
  • Fax: 509-232-0666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AARON WILSON
Title or Position: CEO
Credential:
Phone: 509-444-8888