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)	PA10002517	WA
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1699733642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH ASSOCIATION OF SPOKANE

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	:	5901 N LIDGERWOOD ST STE 223
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-1122
Country	:	US
Telephone Number	:	509-444-8888
Fax Number	:	509-444-7806

Authorized Official
Title or Position	:	CEO
Name	:	AARON WILSON
Credential	:
Telephone Number	:	509-444-8888

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	03/15/2023

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Directions to “COMMUNITY HEALTH ASSOCIATION OF SPOKANE ” Practice Location

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