Provider Demographics
NPI:1871839449
Name:MAGBY, SAMANTHA NICHOLE (NP)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:NICHOLE
Last Name:MAGBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1334
Mailing Address - Country:US
Mailing Address - Phone:509-838-2931
Mailing Address - Fax:509-755-6580
Practice Address - Street 1:2713 N ARGONNE RD
Practice Address - Street 2:
Practice Address - City:MILLWOOD
Practice Address - State:WA
Practice Address - Zip Code:99212-2239
Practice Address - Country:US
Practice Address - Phone:509-598-7860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-29
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60644643163WE0003X
CA755968163WM0705X
CA95000096363LF0000X
WA60644644363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical