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General NPI Number Information
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NPI Number | 1831165331
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Entity Type | Organization
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Legal Business Name | SPOKANE EYE CLINIC INC, PS
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 01/11/2018
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Provider Practice Location Address
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Address Line | 427 S BERNARD ST SUITE 200
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City | SPOKANE
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State | WA
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Zip | 99204-2509
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Country | US
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Telephone | 509-456-8150
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Fax | 509-455-9887
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Provider Business Mailing Address
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Address Line | 427 S BERNARD ST SUITE 200
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City | SPOKANE
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State | WA
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Zip | 99204-2509
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Country | US
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Telephone | 509-456-8150
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Fax | 509-455-9887
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MONICA SUE NEPPER
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Credential |
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Telephone | 509-456-0107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | 600012071
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | ASF.FS.60101697
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License Number State | WA
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