Provider Demographics
NPI:1407487648
Name:DIRECT PRIMARY CARE
Entity Type:Organization
Organization Name:DIRECT PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:DINSMORE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:509-230-4310
Mailing Address - Street 1:212 E CENTRAL AVE STE 360
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4502
Mailing Address - Country:US
Mailing Address - Phone:509-553-0565
Mailing Address - Fax:
Practice Address - Street 1:212 E CENTRAL AVE STE 360
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-4502
Practice Address - Country:US
Practice Address - Phone:509-553-0565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty