Provider Demographics
NPI:1811996390
Name:RAMIREZ, JEFF L (ARNP)
Entity type:Individual
Prefix:MR
First Name:JEFF
Middle Name:L
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 E 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-5412
Mailing Address - Country:US
Mailing Address - Phone:509-535-4001
Mailing Address - Fax:509-533-0627
Practice Address - Street 1:140 S ARTHUR ST
Practice Address - Street 2:SUITE 415
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2204
Practice Address - Country:US
Practice Address - Phone:509-535-4001
Practice Address - Fax:509-533-0627
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA025804 AP30006161363LP0808X
WA025804 AP30006161363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB40038Medicaid
WAQ012267Medicare ID - Type Unspecified