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General NPI Number Information
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NPI Number | 1275216764
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Entity Type | Organization
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Legal Business Name | ONDEMAND PROVIDER SERVICES, PLLC
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 16609 E DESMET CT
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-3545
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Country | US
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Telephone | 844-933-6263
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Fax | 844-444-1159
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Provider Business Mailing Address
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Address Line | 506 N SULLIVAN RD STE F PMB 217
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City | SPOKANE VALLEY
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State | WA
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Zip | 99037-8543
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Country | US
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Telephone | 844-933-6263
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Fax | 844-444-1159
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Authorized Official
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Title or Position | OWNER
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Name | BRADLEY HILLIARD-LYTHGOE
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Credential | ARNP
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Telephone | 844-933-6263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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