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Individual

DR. KIMBERLY ANN GRANDINETTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
322 W NORTH RIVER DR, SPOKANE, WA 99201-3208
(509) 324-6464
(509) 324-3726
Mailing address
322 W NORTH RIVER DR, SPOKANE, WA 99201-3208
(509) 324-6464
(509) 324-3726

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00046330
WA
208000000X
Pediatrics Physician
MD23090
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8459828
WA
01
G8862602
MEDICARE PTAN
WA
01
P00419722
MEDICARE RR
WA
Enumeration date
08/18/2005
Last updated
02/09/2012
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