Provider Demographics
NPI:1225103625
Name:GRINDELAND, ISAAC RUBEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:RUBEN
Last Name:GRINDELAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3405
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3405
Mailing Address - Country:US
Mailing Address - Phone:509-892-2700
Mailing Address - Fax:509-892-2740
Practice Address - Street 1:13103 E MANSFIELD AVENUE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1642
Practice Address - Country:US
Practice Address - Phone:509-892-2700
Practice Address - Fax:509-892-2740
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35092144207ZP0102X
WAMD60414708207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2035974Medicaid