Provider Demographics
NPI:1114071271
Name:CHASE, JOAN C (ARNP, CS)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:C
Last Name:CHASE
Suffix:
Gender:F
Credentials:ARNP, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 N WASHINGTON ST STE 214
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2401
Mailing Address - Country:US
Mailing Address - Phone:509-325-0202
Mailing Address - Fax:509-325-2813
Practice Address - Street 1:1212 N WASHINGTON ST STE 214
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2401
Practice Address - Country:US
Practice Address - Phone:509-325-0202
Practice Address - Fax:509-325-2813
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005304363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9620865Medicaid
WA9620865Medicaid
518134Medicare UPIN