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General NPI Number Information
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NPI Number | 1073720538
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Entity Type | Organization
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Legal Business Name | COLUMBIA MEDICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 09/06/2007
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Provider Practice Location Address
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Address Line | 1003 E TRENT AVE SUITE 150
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City | SPOKANE
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State | WA
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Zip | 99202-2180
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Country | US
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Telephone | 509-688-6701
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Fax | 509-688-6777
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Provider Business Mailing Address
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Address Line | PO BOX 3867
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City | SPOKANE
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State | WA
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Zip | 99220-3867
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Country | US
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Telephone | 509-688-6701
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Fax | 509-688-6777
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | ALICIA SHOBER-KLOTZ
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Credential | PROVIDER RELATIONS
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Telephone | 509-688-6733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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