Provider Demographics
NPI:1740474071
Name:PITTMAN, JAMES F (PHD ARNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:PITTMAN
Suffix:
Gender:M
Credentials:PHD ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9103 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1251
Mailing Address - Country:US
Mailing Address - Phone:509-467-6060
Mailing Address - Fax:509-467-6518
Practice Address - Street 1:9103 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1251
Practice Address - Country:US
Practice Address - Phone:509-467-6060
Practice Address - Fax:509-467-6518
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003001363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9617986Medicaid
WAS45312Medicare UPIN
WAAB34314Medicare PIN