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NPI Code Detail

MEDICARE: ZOEY MCKENNA GUSTAFSON ARNP

MEDICARE: ZOEY MCKENNA GUSTAFSON ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAP61335763WA
2163W00000XRegistered NurseRN60842399WA

General Provider Information

NPI Number : 1235796251
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZOEY MCKENNA GUSTAFSON ARNP
Provider Business Mailing Address
First Line : 611 N IRON BRIDGE WAY
Second Line :
City : SPOKANE
State : WA
Zip : 99202-4932
Country : US
Telephone Number : 509-444-8888
Fax Number : 509-444-7806
Provider Business Practice Location Address
First Line : 3919 N MAPLE ST
Second Line :
City : SPOKANE
State : WA
Zip : 99205-1349
Country : US
Telephone Number : 509-444-8200
Fax Number : 509-434-0392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2019
Last Update Date : 03/10/2026

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Directions to “ ZOEY MCKENNA GUSTAFSON ARNP” Practice Location

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