Provider Demographics
NPI:1609957984
Name:OB/GYN ASSOCIATES OF SPOKANE, PS
Entity Type:Organization
Organization Name:OB/GYN ASSOCIATES OF SPOKANE, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-455-8866
Mailing Address - Street 1:601 W 5TH AVE
Mailing Address - Street 2:SUITE #301
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2705
Mailing Address - Country:US
Mailing Address - Phone:509-455-8866
Mailing Address - Fax:509-838-3411
Practice Address - Street 1:601 W 5TH AVE
Practice Address - Street 2:SUITE #301
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2705
Practice Address - Country:US
Practice Address - Phone:509-455-8866
Practice Address - Fax:509-838-3411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDK2665OtherGROUP NUMBER
WA7036577Medicaid