Healthcare Provider Details

I. General information

NPI: 1265353460
Provider Name (Legal Business Name): DAWN N JEATOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PBS, 205 E SPOKANE FALLS BLVD
SPOKANE WA
99202-2131
US

IV. Provider business mailing address

506 3RD ST APT 2
CHENEY WA
99004-7016
US

V. Phone/Fax

Practice location:
  • Phone: 509-368-6700
  • Fax:
Mailing address:
  • Phone: 360-622-1459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number61585825
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: