Healthcare Provider Details

I. General information

NPI: 1871977454
Provider Name (Legal Business Name): SAMANTHA K. MATHEWS-KLEBES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2015
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 E FRONT AVE
SPOKANE WA
99202-2139
US

IV. Provider business mailing address

PO BOX 31001-4114
PASADENA CA
91110-0001
US

V. Phone/Fax

Practice location:
  • Phone: 509-626-9904
  • Fax: 509-227-7070
Mailing address:
  • Phone: 866-747-2455
  • Fax: 509-227-7070

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 TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19319
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD61067712
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD61067712
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: