Organization
COMMUNITY HEALTH ASSOCIATION OF SPOKANE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN HALVORSON (CHIEF COMPLIANCE OFFICER)
(509) 444-8888
Entity
Organization
Contact information
Practice address
803 S MAIN ST STE 120, MOSCOW, ID 83843
(208) 848-8300
(208) 882-5587
Mailing address
731 N IRON BRIDGE WAY, SPOKANE, WA 99202-4926
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1369012
MEDICARE PART B PTAN
ID
Enumeration date
10/11/2016
Last updated
01/05/2026
Update your record
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