Provider Demographics
NPI:1366625642
Name:ANYA CONSIGLIO MD, PS
Entity Type:Organization
Organization Name:ANYA CONSIGLIO MD, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ANYA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CONSIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-489-4040
Mailing Address - Street 1:406 E ROWAN AVE
Mailing Address - Street 2:SUITE200
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1201
Mailing Address - Country:US
Mailing Address - Phone:509-489-4040
Mailing Address - Fax:509-489-9190
Practice Address - Street 1:406 E ROWAN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1201
Practice Address - Country:US
Practice Address - Phone:509-489-4040
Practice Address - Fax:509-489-9190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00048498207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1366625642OtherNPI CORP
WA226211OtherLABOR & INDUSTRY
WA4954COOtherASURIS
WA8870436OtherMEDICARE
WADN2383OtherRAILROAD MEDICARE GROUP
WAP00610288OtherRAILROAD MEDICARE- PTAN GROUP MEMBER NUMBER
WA1659458404OtherNPI DOCTOR
WA1124569Medicaid
WA1124569Medicaid