Provider Demographics
NPI:1497209654
Name:TRUE NORTH HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:TRUE NORTH HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-473-9313
Mailing Address - Street 1:5901 N LIDGERWOOD ST
Mailing Address - Street 2:21 B
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-5095
Mailing Address - Country:US
Mailing Address - Phone:509-473-9313
Mailing Address - Fax:509-822-7413
Practice Address - Street 1:5901 N LIDGERWOOD ST
Practice Address - Street 2:21 B
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-5095
Practice Address - Country:US
Practice Address - Phone:509-473-9313
Practice Address - Fax:509-822-7413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-05
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60107301261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q08823Medicare UPIN