Individual
JUSTIN EBERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-3260
(509) 474-3245
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OP60764910
WA
207R00000X
Internal Medicine Physician
OS015253
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102478339
—
PA
Enumeration date
05/18/2007
Last updated
07/21/2022
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