Healthcare Provider Details

I. General information

NPI: 1578995288
Provider Name (Legal Business Name): IRENE GERDA BAYER P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRENE GERDA KLARMEYER P.A.

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 E FARWELL RD STE 206
SPOKANE WA
99218-8208
US

IV. Provider business mailing address

309 E FARWELL RD STE 206
SPOKANE WA
99218-8208
US

V. Phone/Fax

Practice location:
  • Phone: 509-484-4591
  • Fax: 509-484-7882
Mailing address:
  • Phone: 509-484-4591
  • Fax: 509-484-7882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA10004453
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: