Provider Demographics
NPI:1497763585
Name:DRS. GOLDMAN & SUMMERS, PLLC
Entity Type:Organization
Organization Name:DRS. GOLDMAN & SUMMERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHIESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-467-8355
Mailing Address - Street 1:9631 N NEVADA ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1197
Mailing Address - Country:US
Mailing Address - Phone:509-467-8355
Mailing Address - Fax:509-467-7151
Practice Address - Street 1:9631 N NEVADA ST STE 210
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1197
Practice Address - Country:US
Practice Address - Phone:509-467-8355
Practice Address - Fax:509-467-7151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020871207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA000010147266OtherREGENCE BLUESHIELD OF IDA
WAKW773OtherBLUE CROSS OF IDAHO
WAP00124645OtherRAILROAD MEDICARE
WA000010147265OtherREGENCE BLUESHIELD OF IDA
WAP00165602OtherRAILROAD MEDICARE
WAP00240230OtherRAILROAD MEDICARE
WAPOO124661OtherRAILROAD MEDICARE
WA7123839Medicaid
WA163050OtherLABOR & INDUSTRIES
WAPOO124661OtherRAILROAD MEDICARE
WA000010147265OtherREGENCE BLUESHIELD OF IDA
WA000010147266OtherREGENCE BLUESHIELD OF IDA
WAKW773OtherBLUE CROSS OF IDAHO
WAQ19551Medicare UPIN