Provider Demographics
NPI:1942323274
Name:ORTHOPAEDIC SPECIALTY CLINIC OF SPOKANE
Entity Type:Organization
Organization Name:ORTHOPAEDIC SPECIALTY CLINIC OF SPOKANE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-466-6393
Mailing Address - Street 1:785 E HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1257
Mailing Address - Country:US
Mailing Address - Phone:509-466-6393
Mailing Address - Fax:509-466-5163
Practice Address - Street 1:785 E HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1257
Practice Address - Country:US
Practice Address - Phone:509-466-6393
Practice Address - Fax:509-466-5163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5874430001Medicare NSC