Provider Demographics
NPI:1598046260
Name:ARGONNE MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:ARGONNE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:GOLDFELDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-927-2777
Mailing Address - Street 1:826 N MULLAN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4094
Mailing Address - Country:US
Mailing Address - Phone:509-927-2227
Mailing Address - Fax:509-928-8592
Practice Address - Street 1:826 N MULLAN RD
Practice Address - Street 2:SUITE A
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4094
Practice Address - Country:US
Practice Address - Phone:509-927-2227
Practice Address - Fax:509-928-8592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30000070363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA96002210Medicaid
WA96002210Medicaid