Provider Demographics
NPI:1821100132
Name:NORTH SPOKANE WOMENS HEALTH PS
Entity Type:Organization
Organization Name:NORTH SPOKANE WOMENS HEALTH PS
Other - Org Name:WAS: NORTH SPOKANE WOMENS CLINIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:TREASURER/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-489-2101
Mailing Address - Street 1:235 E. ROWAN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1240
Mailing Address - Country:US
Mailing Address - Phone:509-489-2101
Mailing Address - Fax:509-252-1561
Practice Address - Street 1:235 E. ROWAN
Practice Address - Street 2:SUITE 102
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1240
Practice Address - Country:US
Practice Address - Phone:509-489-2101
Practice Address - Fax:509-252-1561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7022247Medicaid
WA1811993488Medicare PIN
WA1164429742Medicare PIN
WA1467563304Medicare PIN
WA1285630855Medicare PIN
WA1821100132Medicare PIN
WA1700883121Medicare PIN
WA7022247Medicaid