MEDICARE: ISD RENAL INC

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	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1881640720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISD RENAL INC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	ATT: L&C DEPT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7701 N DIVISION ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-5615
Country	:	US
Telephone Number	:	509-465-3161
Fax Number	:	509-465-1812

Authorized Official
Title or Position	:	VP LICENSURE & CERTIFICATION
Name	:	SAMUEL T WEY
Credential	:
Telephone Number	:	615-341-6641

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	12/01/2025

Similar Medicare Providers

1134265945 — MICHAEL NORWOOD PHARM.D.
Practice Location Address:

5615 W SUNSET HWY
SPOKANE, WA
99224-9454

Practice Phone: 509-241-7595
Practice Fax:

1902944242 — GALEN W. GOERTZEN
Practice Location Address:

5615 W SUNSET HWY
SPOKANE, WA
99224-9454

Practice Phone: 509-241-7572
Practice Fax: 509-434-3118

1992849848 — MICHAEL D. EVANS M.D.
Practice Location Address:

5615 W SUNSET HWY
SPOKANE, WA
99224-9454

Practice Phone: 206-901-6117
Practice Fax: 206-901-6108

1588105308 — PINE RIDGE MANAGEMENT WA LLC
Practice Location Address:

5615 WEST UMATILLA
SPOKANE, WA
99206

Practice Phone: 509-924-4388
Practice Fax:

1851863625 — ASHLEY J BUSCH LICSW
Practice Location Address:

5615 W SUNSET HWY
SPOKANE, WA
99224-9454

Practice Phone: 509-324-3740
Practice Fax:

1720462666 — DR. JACLYN M ELIASSEN DDS
Practice Location Address:

5011 W LOWELL AVE , SUITE 130
SPOKANE, WA
99208-8587

Practice Phone: 509-464-3100
Practice Fax:

Directions to “ISD RENAL INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.