Provider Demographics
NPI:1801114129
Name:INLAND CARDIOLOGY ASSOCIATES PS
Entity type:Organization
Organization Name:INLAND CARDIOLOGY ASSOCIATES PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DURKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-664-4026
Mailing Address - Street 1:122 W 7TH AVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2332
Mailing Address - Country:US
Mailing Address - Phone:509-838-2960
Mailing Address - Fax:509-459-0424
Practice Address - Street 1:122 W 7TH AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2332
Practice Address - Country:US
Practice Address - Phone:509-838-2960
Practice Address - Fax:509-459-0424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA6011816363A00000X
WAAP30003426363L00000X
WAAP30007150363L00000X
WAAP30006427363L00000X
WAAP30007497363L00000X
WAPA10003131363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty