Provider Demographics
NPI:1720394521
Name:DRUMM, JOSHUA ELLIS (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ELLIS
Last Name:DRUMM
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:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:509-252-1977
Mailing Address - Fax:
Practice Address - Street 1:212 E CENTRAL AVE STE 245
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208
Practice Address - Country:US
Practice Address - Phone:509-252-1977
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60349600207X00000X
WAOL60156404207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8932550Medicare UPIN