Provider Demographics
NPI:1508854159
Name:JAMES F PITTMAN PHD ARNP PS
Entity Type:Organization
Organization Name:JAMES F PITTMAN PHD ARNP PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTICE ARNP
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ARNP
Authorized Official - Phone:509-467-6060
Mailing Address - Street 1:9103 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1251
Mailing Address - Country:US
Mailing Address - Phone:509-467-6060
Mailing Address - Fax:509-467-6518
Practice Address - Street 1:9103 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1251
Practice Address - Country:US
Practice Address - Phone:509-467-6060
Practice Address - Fax:509-467-6518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003001363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9617986Medicaid
WAAB34312Medicare PIN