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Organization
FOOT & ANKLE CLINIC OF SPOKANE
Active
Organization
FOOT & ANKLE CLINIC OF SPOKANE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE M BABOL DPM (OWNER DOCTOR)
(509) 928-8181
Entity
Organization
Contact information
Practice address
9405 E SPRAGUE AVE, SPOKANE VALLEY, WA 99206-3694
(509) 928-8181
(509) 926-1247
Mailing address
9405 E SPRAGUE AVE, POB 13070, SPOKANE VALLEY, WA 99206-3694
(509) 928-8181
(509) 926-1247
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO00000715
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1116623
—
WA
01
—
4797370001
DMERC PIN
WA
01
—
693OBO
REGENCE
WA
01
—
9055492
DSHS DMERC
WA
Enumeration date
08/22/2005
Last updated
08/22/2020
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