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General NPI Number Information
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NPI Number | 1508655184
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Entity Type | Organization
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Legal Business Name | DYNAMIC SPINE AND PAIN INSTITUTE PLLC
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 9715 N NEVADA ST
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City | SPOKANE
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State | WA
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Zip | 99218-3412
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Country | US
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Telephone | 509-297-7463
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Fax | 509-292-6801
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Provider Business Mailing Address
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Address Line | 9715 N NEVADA ST
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City | SPOKANE
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State | WA
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Zip | 99218-3412
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INTERIM OFFICE MANAGER
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Name | JENAE O'RIELLEY
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Credential |
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Telephone | 801-903-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 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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