MEDICARE: COMMUNITY HEALTH ASSOCIATION OF SPOKANE

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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1417731951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH ASSOCIATION OF SPOKANE

Provider Business Mailing Address
First Line	:	731 N IRON BRIDGE WAY
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99202-4926
Country	:	US
Telephone Number	:	509-444-8888
Fax Number	:	509-444-7806

Provider Business Practice Location Address
First Line	:	1600 N HOWARD ST RM 115
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-4705
Country	:	US
Telephone Number	:	509-444-8888
Fax Number	:	509-444-7810

Authorized Official
Title or Position	:	CORPORATE COMPLIANCE OFFICER
Name	:	NATHAN HALVORSON
Credential	:
Telephone Number	:	509-444-8888

Provider Enumeration Date	:	08/24/2023
Last Update Date	:	01/05/2026

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