Individual
DR. JEFFERY STUART GIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16528 E DESMET CT, SPOKANE VALLEY, WA 99216-3522
(509) 944-8907
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 944-9644
(509) 944-9644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60080776
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080103355
RR MEDICARE PTAN NUMBER
OR
05
—
081443
—
OR
01
—
1407812365
NBMC NPI NUMBER-GROUP
OR
01
—
930635514
GROUP TAX NUMBER
OR
01
—
CD8723
RR MEDICARE GROUP NUMBER
OR
01
—
R0000WFBTV
GROUP PIN NUMBER
OR
Enumeration date
12/06/2005
Last updated
05/11/2022
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