Individual
JOSEPH D PHANEUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-3260
(509) 474-2245
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 474-2072
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00036029
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1103936
—
WA
01
—
121414
L & I
—
05
—
8473381
—
WA
01
—
CG4026
MEDCIARE RR GROUP
WA
01
—
G000362000
MEDICARE GROUP NUMBER
WA
01
—
P00395895
MEDICARE RR NUMBER
WA
Enumeration date
09/01/2006
Last updated
06/24/2021
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