Provider Demographics
NPI:1215358841
Name:ROSS, SELINA MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SELINA
Middle Name:MARIE
Last Name:ROSS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9631 N NEVADA ST
Mailing Address - Street 2:STE 205
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1193
Mailing Address - Country:US
Mailing Address - Phone:509-466-1271
Mailing Address - Fax:509-466-0969
Practice Address - Street 1:9631 N NEVADA ST
Practice Address - Street 2:STE 205
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1193
Practice Address - Country:US
Practice Address - Phone:509-466-1271
Practice Address - Fax:509-466-0969
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-28
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60417500363LC1500X
WAAP60417500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily