Provider Demographics
NPI:1497835698
Name:CUMMENS, TROY (DO)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:
Last Name:CUMMENS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W 5TH AVE STE 230E
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4808
Mailing Address - Country:US
Mailing Address - Phone:509-838-8561
Mailing Address - Fax:
Practice Address - Street 1:104 W 5TH AVE STE 230E
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4808
Practice Address - Country:US
Practice Address - Phone:509-838-8561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO862207L00000X
WAOP00002269207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8485922Medicaid
WA8485922Medicaid
8867144Medicare PIN