Healthcare Provider Details

I. General information

NPI: 1639933989
Provider Name (Legal Business Name): AUDRIANNA DEMARS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 8TH AVE STE 200
SPOKANE WA
99204-2318
US

IV. Provider business mailing address

PO BOX 31001
PASADENA CA
91110-4114
US

V. Phone/Fax

Practice location:
  • Phone: 509-624-9112
  • Fax: 509-624-1087
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP70012047
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN61205615
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: