Individual
JAN STUART CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
217 W CATALDO, SPOKANE, WA 99201-2217
(509) 624-2326
(509) 744-3040
Mailing address
217 W CATALDO, SPOKANE, WA 99201-2217
(509) 624-2326
(509) 744-3040
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD000019284
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1784701
—
WA
01
—
99107
L & I
WA
Enumeration date
05/13/2006
Last updated
03/16/2010
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