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NPI Code Detail

MEDICARE: MATTHEW GERRIT BULETTI CP

MEDICARE: MATTHEW GERRIT BULETTI CP
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
1224P00000XProsthetist

General Provider Information

NPI Number : 1841160322
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW GERRIT BULETTI CP
Provider Business Mailing Address
First Line : 401 S SHERMAN ST
Second Line :
City : SPOKANE
State : WA
Zip : 99202-6001
Country : US
Telephone Number : 509-624-1308
Fax Number : 509-624-5537
Provider Business Practice Location Address
First Line : 401 S SHERMAN ST
Second Line :
City : SPOKANE
State : WA
Zip : 99202-6001
Country : US
Telephone Number : 509-624-1308
Fax Number : 509-624-5537
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2025
Last Update Date : 11/10/2025

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Directions to “ MATTHEW GERRIT BULETTI CP” Practice Location

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