Organization
SPOKANE PLASTIC SURGEONS PS
Active
Other names
Spokane Plastic Surgeons Surgicenter
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLENE ANN CROW (OFFICE MANAGER)
(509) 484-1212
Entity
Organization
Contact information
Practice address
235 E ROWAN AVE, STE 206, SPOKANE, WA 99207-1240
(509) 484-1212
(509) 484-1277
Mailing address
235 E ROWAN AVE, STE 206, SPOKANE, WA 99207-1240
(509) 484-1212
(509) 484-1277
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
WA
261QA1903X
Ambulatory Surgical Clinic/Center
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108585
L&I GROUP PROVIDER #
WA
01
—
555
GHC GROUP PROVIDER #
WA
05
—
7091358
—
WA
01
—
K9751
BC-IDAHO MANAGED CARE GR#
ID
Enumeration date
08/03/2006
Last updated
10/10/2007
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