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General NPI Number Information
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NPI Number | 1083607477
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Entity Type | Organization
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Legal Business Name | SPOKANE RADIATION ONCOLOGY ASSOCIATES P S
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 700 W IRONWOOD DR
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2656
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Country | US
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Telephone | 208-666-3800
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Fax | 208-666-3817
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Provider Business Mailing Address
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Address Line | PO BOX 405
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City | SPOKANE
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State | WA
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Zip | 99210-0405
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Country | US
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Telephone | 208-667-9334
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Fax | 208-664-2341
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | DR. DAVID E DAVENPORT
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Credential | MD
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Telephone | 208-666-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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