Organization
PATHOLOGY SERVICES PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRBY COSSETTE M.D. (PRESIDENT)
(509) 473-7393
Entity
Organization
Contact information
Practice address
800 W 5TH AVE, SPOKANE, WA 99204-2803
(509) 473-7393
(509) 473-7016
Mailing address
PO BOX 66500, PORTLAND, OR 97290-6500
(503) 657-8663
(503) 723-3180
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268617
—
OR
05
—
7009905
—
WA
05
—
805184100
—
ID
01
—
CS9148
MEDICARE RAILROAD
—
Enumeration date
06/06/2006
Last updated
09/17/2008
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