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Individual

MAXSWELL A HACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1212 N PINES RD, SPOKANE VALLEY, WA 99206-4939
(509) 893-8140
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 893-8140

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
843708
CA
363L00000X
Nurse Practitioner
Primary
78680
ID
363L00000X
Nurse Practitioner
AP60711448
WA
363LF0000X
Family Nurse Practitioner
78680
ID

Other

Enumeration date
11/04/2016
Last updated
03/17/2025
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