Organization
A COMMUNITY WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY LEE TRAUGOTT DNP (OWNER)
(509) 720-8516
Entity
Organization
Contact information
Practice address
2405 E 17TH AVE STE 113, SPOKANE, WA 99223-5122
(509) 720-8516
Mailing address
2405 E 17TH AVE STE 113, SPOKANE, WA 99223-5122
(509) 720-8516
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396118469
NPI
—
Enumeration date
10/29/2019
Last updated
05/13/2026
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