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General NPI Number Information
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NPI Number | 1386460822
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Entity Type | Individual
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Provider Name | MINDY BOONE
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 2304 E 5TH AVE
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City | SPOKANE
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State | WA
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Zip | 99202-4170
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Country | US
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Telephone | 509-378-2492
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Fax | 509-461-8677
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Provider Business Mailing Address
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Address Line | 610 W FENDER RD
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City | COLBERT
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State | WA
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Zip | 99005-9605
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Country | US
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Telephone | 509-378-2492
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Fax | 509-461-8677
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HM60741994
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License Number State | WA
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