Healthcare Provider Details

I. General information

NPI: 1083932396
Provider Name (Legal Business Name): MEDICAL ONCOLOGY ASSOCIATES PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 N MAYFAIR ST
SPOKANE WA
99208-1129
US

IV. Provider business mailing address

13424 E MISSION AVE
SPOKANE VALLEY WA
99216-2759
US

V. Phone/Fax

Practice location:
  • Phone: 509-462-2273
  • Fax: 509-462-2275
Mailing address:
  • Phone: 95-774-0154
  • Fax: 833-439-0069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60081731
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30006441
License Number StateWA

VIII. Authorized Official

Name: SHERRY J CLEVELAND
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 509-774-0154