MEDICARE: MR. TAMOSS IKEI CARNES MSW

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
1	171M00000X	Case Manager/Care Coordinator
2	225400000X	Rehabilitation Practitioner
3	1041C0700X	Clinical Social Worker	SC61662004	WA

General Provider Information

NPI Number	:	1285769141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TAMOSS IKEI CARNES MSW

Provider Business Mailing Address
First Line	:	100 N HOWARD ST STE W
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-0508
Country	:	US
Telephone Number	:	424-419-7858
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 N HOWARD ST STE W
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-0508
Country	:	US
Telephone Number	:	424-419-7858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	07/15/2025

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