Provider Demographics
NPI:1770799652
Name:RUBIN, DIANE (MD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 W RIVERSIDE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1010
Mailing Address - Country:US
Mailing Address - Phone:509-353-3105
Mailing Address - Fax:
Practice Address - Street 1:920 W RIVERSIDE AVE
Practice Address - Street 2:SUITE 200, MEPS
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1010
Practice Address - Country:US
Practice Address - Phone:509-353-3105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029014207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE18696Medicare UPIN