Provider Demographics
NPI:1770997934
Name:COLVIN, JENNIFER C (DO)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:COLVIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:C
Other - Last Name:HORSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 3649
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3649
Mailing Address - Country:US
Mailing Address - Phone:509-838-2531
Mailing Address - Fax:303-763-5495
Practice Address - Street 1:2214 E 29TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3939
Practice Address - Country:US
Practice Address - Phone:509-755-5250
Practice Address - Fax:509-755-5251
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0055690207Q00000X
WA60962516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine