Provider Demographics
NPI:1356513014
Name:SPENDLOVE, JOSHUA DAHL (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DAHL
Last Name:SPENDLOVE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6128
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-0128
Mailing Address - Country:US
Mailing Address - Phone:509-221-6550
Mailing Address - Fax:509-221-6511
Practice Address - Street 1:3730 PLAZA WAY FL 5
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-2718
Practice Address - Country:US
Practice Address - Phone:506-221-6550
Practice Address - Fax:509-221-6511
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2014-0118208800000X
AZ76400208800000X
WAMD60762111208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA208449Medicaid