Individual
CATHERINE C BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
212 E CENTRAL AVE STE 240, SPOKANE, WA 99208-6597
(509) 455-8820
Mailing address
PO BOX 331, LIBERTY LAKE, WA 99019-0331
(866) 747-2455
(509) 944-9644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7072
AZ
363A00000X
Physician Assistant
Primary
PA10004690
WA
363A00000X
Physician Assistant
PA159129
OR
363AM0700X
Medical Physician Assistant
PA10004690
WA
363AS0400X
Surgical Physician Assistant
PA10004690
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0194214
L&I
WA
05
—
500648665
—
OR
05
—
8415937
—
WA
Enumeration date
06/30/2006
Last updated
10/21/2024
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