Provider Demographics
NPI:1235712621
Name:ATTICUS HEALTH, PLLC
Entity Type:Organization
Organization Name:ATTICUS HEALTH, PLLC
Other - Org Name:ATTICUS HEALTH, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LINER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:509-495-1810
Mailing Address - Street 1:12615 E MISSION AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1047
Mailing Address - Country:US
Mailing Address - Phone:509-495-1810
Mailing Address - Fax:509-676-4768
Practice Address - Street 1:12615 E MISSION AVE STE 105
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1047
Practice Address - Country:US
Practice Address - Phone:509-495-1810
Practice Address - Fax:509-676-4768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty