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General NPI Number Information
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NPI Number | 1285626622
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE CLINIC OF SPOKANE
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9405 E SPRAGUE AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-3694
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Country | US
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Telephone | 509-928-8181
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Fax | 509-926-1247
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Provider Business Mailing Address
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Address Line | 9405 E SPRAGUE AVE POB 13070
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-3694
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Country | US
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Telephone | 509-928-8181
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Fax | 509-926-1247
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. JACQUELINE M BABOL
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Credential | DPM
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Telephone | 509-928-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO00000715
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License Number State | WA
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