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General NPI Number Information
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NPI Number | 1013923960
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Entity Type | Individual
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Provider Name | JOHN HEUSNER MD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 104 WEST 5TH AVE SUITE 203E
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City | SPOKANE
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State | WA
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Zip | 99204-2483
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Country | US
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Telephone | 509-838-8561
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Fax | 509-835-4058
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Provider Business Mailing Address
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Address Line | 104 WEST 5TH AVE SUITE 203E
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City | SPOKANE
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State | WA
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Zip | 99204-2483
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Country | US
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Telephone | 509-838-8828
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Fax | 509-835-4058
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 31723
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License Number State | WA
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