Provider Demographics
NPI:1134462732
Name:SPOKANE VALLEY NEUROPATHY RELIEF CENTER, P.S.
Entity Type:Organization
Organization Name:SPOKANE VALLEY NEUROPATHY RELIEF CENTER, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:DINSMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-230-4310
Mailing Address - Street 1:12409 E MISSION AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-3101
Mailing Address - Country:US
Mailing Address - Phone:509-926-5117
Mailing Address - Fax:509-926-5197
Practice Address - Street 1:12409 E MISSION AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-3101
Practice Address - Country:US
Practice Address - Phone:509-926-5117
Practice Address - Fax:509-926-5197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8919121Medicare PIN
WAG8919121Medicare UPIN