Healthcare Provider Details

I. General information

NPI: 1386730844
Provider Name (Legal Business Name): MARC SCHILLIOS MSN, FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W MISSION AVE
SPOKANE WA
99201-2358
US

IV. Provider business mailing address

PO BOX 190
TOPPENISH WA
98948-0190
US

V. Phone/Fax

Practice location:
  • Phone: 509-326-4343
  • Fax: 509-329-2280
Mailing address:
  • Phone: 509-865-2395
  • Fax: 509-865-0757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30001776
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: