Organization
SPOKANE RADIATION ONCOLOGY ASSOCIATES P S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID E DAVENPORT MD (DELEGATED OFFICIAL)
(208) 666-3800
Entity
Organization
Contact information
Practice address
700 W IRONWOOD DR, COEUR D ALENE, ID 83814-2656
(208) 666-3800
(208) 666-3817
Mailing address
PO BOX 405, SPOKANE, WA 99210-0405
(208) 667-9334
(208) 664-2341
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN8904
RAILROAD MEDICARE
—
Enumeration date
08/31/2005
Last updated
12/04/2007
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