Provider Demographics
NPI:1912179599
Name:DERMATOLOGY SPECIALISTS OF SPOKANE
Entity Type:Organization
Organization Name:DERMATOLOGY SPECIALISTS OF SPOKANE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHAUBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-456-5949
Mailing Address - Street 1:510 S COWLEY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1332
Mailing Address - Country:US
Mailing Address - Phone:509-456-8444
Mailing Address - Fax:509-455-9227
Practice Address - Street 1:510 S COWLEY ST STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1332
Practice Address - Country:US
Practice Address - Phone:509-456-8444
Practice Address - Fax:509-455-9227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023695207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty