Provider Demographics
NPI:1215012331
Name:SPOKANE FOOT CLINIC, PS
Entity Type:Organization
Organization Name:SPOKANE FOOT CLINIC, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-483-9363
Mailing Address - Street 1:123 W FRANCIS
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205
Mailing Address - Country:US
Mailing Address - Phone:509-483-9363
Mailing Address - Fax:509-483-0355
Practice Address - Street 1:123 W FRANCIS
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205
Practice Address - Country:US
Practice Address - Phone:509-483-9363
Practice Address - Fax:509-483-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACU0224OtherRAILROAD MEDICARE
WA7074396Medicaid
WAG319208200Medicare PIN
0957310001Medicare NSC