Provider Demographics
NPI:1508848276
Name:LINEHAN, BARRY E (PA-C)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:E
Last Name:LINEHAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:611 N IRON BRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-4932
Mailing Address - Country:US
Mailing Address - Phone:509-444-8888
Mailing Address - Fax:509-434-1931
Practice Address - Street 1:1502 N VERCLER RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1078
Practice Address - Country:US
Practice Address - Phone:095-444-8200
Practice Address - Fax:509-489-0686
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2023-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10004651363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAS98579Medicare UPIN