NPI 1033154273

Spokane Ent Clinic Mayfair

Organisation Non-Pharmacy Dispensing Site Spokane, WA

Practice location

Address: 5901 N Mayfair St, Spokane, WA 99208-5096
Phone: (509) 489-3514
Fax: (509) 483-2546

Authorised official

Name: Direndia Shackelford
Title: Managed Care Specialist
Phone: (800) 654-0889

Registered specialties

Non-Pharmacy Dispensing Site Primary

Suppliers Taxonomy 332900000X Licence MD00019284 (WA)

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Registry record

NPI: 1033154273
Entity type: Organization
NPI issued: 20 Jun 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.