Provider Demographics
NPI:1407039555
Name:VALLEY ORTHOPEDIC CLINIC, P.S.
Entity Type:Organization
Organization Name:VALLEY ORTHOPEDIC CLINIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:KELP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-928-5661
Mailing Address - Street 1:12525 E MISSION AVE
Mailing Address - Street 2:STE 107
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1063
Mailing Address - Country:US
Mailing Address - Phone:509-928-5661
Mailing Address - Fax:509-891-6302
Practice Address - Street 1:12525 E MISSION AVE
Practice Address - Street 2:STE 107
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1063
Practice Address - Country:US
Practice Address - Phone:509-928-5661
Practice Address - Fax:509-891-6302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty