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General NPI Number Information
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NPI Number | 1588857924
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Entity Type | Organization
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Legal Business Name | SPOKANE CLINIC FOR RECTAL AND COLON DISEASE, PS
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 5515 S CUSTER RD
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City | SPOKANE
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State | WA
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Zip | 99223-1628
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Country | US
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Telephone | 509-448-2278
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Fax |
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Provider Business Mailing Address
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Address Line | 5515 S CUSTER RD
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City | SPOKANE
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State | WA
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Zip | 99223-1628
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Country | US
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Telephone | 509-448-2278
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES C. S. COLQUHOUN
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Credential | MD
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Telephone | 509-448-2278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 600108525
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License Number State | WA
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