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Organization
WA-SPOK PRIMARY CARE LLC
Active
Organization
WA-SPOK PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBIBE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
1603 NORTH BELT, SPOKANE, WA 99205-4038
(509) 473-7060
(509) 326-0521
Mailing address
1603 NORTH BELT, SPOKANE, WA 99205-4038
(509) 473-7060
(509) 326-0521
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
NULL
208M00000X
Hospitalist Physician
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
—
NULL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
—
—
367A00000X
Advanced Practice Midwife
—
NULL
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7144546
—
WA
Enumeration date
09/19/2008
Last updated
02/13/2012
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