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General NPI Number Information
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NPI Number | 1275251456
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Entity Type | Organization
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Legal Business Name | DREAMTIME ANESTHESIA LLC
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 1424 N MCDONALD RD #101
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City | SPOKANE
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State | WA
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Zip | 99216
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Country | US
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Telephone | 509-928-7272
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Fax | 509-928-7346
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Provider Business Mailing Address
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Address Line | PO BOX 3545
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City | IDAHO FALLS
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State | ID
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Zip | 83403
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Country | US
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Telephone | 208-525-2090
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Fax | 208-523-8978
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JOSHUA PAUL SPARTZ
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Credential | CRNA
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Telephone | 509-847-9835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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