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General NPI Number Information
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NPI Number | 1104242882
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Entity Type | Individual
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Provider Name | SALLY AIKEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 5901 N LIDGERWOOD ST SUITE 24B
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City | SPOKANE
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State | WA
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Zip | 99208-5095
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Country | US
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Telephone | 509-477-2296
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Fax | 509-477-4362
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Provider Business Mailing Address
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Address Line | 5901 N LIDGERWOOD ST SUITE 24B
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City | SPOKANE
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State | WA
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Zip | 99208-5095
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Country | US
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Telephone | 509-477-2296
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Fax | 509-477-4362
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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 | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | MD 00021142
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License Number State | WA
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