Healthcare Provider Details

I. General information

NPI: 1346683539
Provider Name (Legal Business Name): CHASE NICHOLAS DEOBALD D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W 5TH AVE
SPOKANE WA
99204-2803
US

IV. Provider business mailing address

800 W 5TH AVE
SPOKANE WA
99204-2803
US

V. Phone/Fax

Practice location:
  • Phone: 509-999-8272
  • Fax:
Mailing address:
  • Phone: 509-999-8272
  • Fax: 509-473-7403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOP61550122
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number04815
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: