Healthcare Provider Details

I. General information

NPI: 1184589111
Provider Name (Legal Business Name): ELIZABETH R EGGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W GARLAND AVE
SPOKANE WA
99205-2119
US

IV. Provider business mailing address

2404 E EVERETT AVE
SPOKANE WA
99217-6206
US

V. Phone/Fax

Practice location:
  • Phone: 509-818-2187
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberCO61660469
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: