Provider Demographics
NPI:1235859299
Name:LUEDKE, ALLISON LESLIE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:LESLIE
Last Name:LUEDKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W WILLAPA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-5338
Mailing Address - Country:US
Mailing Address - Phone:509-847-4680
Mailing Address - Fax:
Practice Address - Street 1:701 W WILLAPA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-5338
Practice Address - Country:US
Practice Address - Phone:509-847-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61480534363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant