MEDICARE: DARRON WOOLLEY DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	PO00000823	WA

General Provider Information

NPI Number	:	1689724601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRON WOOLLEY DPM

Provider Business Mailing Address
First Line	:	12109 E BROADWAY AVE STE C
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-6133
Country	:	US
Telephone Number	:	509-928-1990
Fax Number	:	509-928-2933

Provider Business Practice Location Address
First Line	:	12109 E BROADWAY AVE STE C
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-6133
Country	:	US
Telephone Number	:	509-928-1990
Fax Number	:

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	02/02/2026

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Directions to “ DARRON WOOLLEY DPM” Practice Location

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