Provider Demographics
NPI:1972261758
Name:SPOMER, CATHERINE (ARNP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:SPOMER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 W 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-7910
Mailing Address - Country:US
Mailing Address - Phone:317-681-3537
Mailing Address - Fax:
Practice Address - Street 1:701 DALE AVE
Practice Address - Street 2:
Practice Address - City:BENTON CITY
Practice Address - State:WA
Practice Address - Zip Code:99320-5250
Practice Address - Country:US
Practice Address - Phone:509-588-4075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61244899363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily