Individual
DR. JOEL D HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 W 8TH AVE, STE. 100, L-1, SPOKANE, WA 99204-2307
(509) 232-1192
(509) 232-1165
Mailing address
910 N WASHINGTON ST, STE. 209, SPOKANE, WA 99201-2202
(509) 232-1192
(509) 232-1165
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
MD00047205
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
807680300
IDAHO MEDICAID
WA
01
—
8480683
WA MEDICAID
WA
01
—
G8864785
MEDICARE PTAN
WA
01
—
GAB32999
MEDICARE GROUP
WA
Enumeration date
03/15/2007
Last updated
03/07/2023
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