Gravida Psychiatry Llc | |
59 E Queen Ave Ste 111c Spokane WA 99207-1430 | |
(509) 596-2199 | |
Not Available |
Full Name | Gravida Psychiatry Llc |
---|---|
Speciality | Nurse Practitioner |
Location | 59 E Queen Ave Ste 111c, Spokane, Washington |
Authorized Official Name and Position | Michael Colver (DIRECTOR) |
Authorized Official Contact | 8017176238 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gravida Psychiatry Llc 4402 W Elderberry Ave Spokane WA 99208-9438 Ph: () - | Gravida Psychiatry Llc 59 E Queen Ave Ste 111c Spokane WA 99207-1430 Ph: (509) 596-2199 |
NPI Number | 1407578263 |
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Provider Enumeration Date | 09/16/2022 |
Last Update Date | 08/07/2025 |
Certification Date | 08/07/2025 |
Medicare PECOS PAC ID | 0648642421 |
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Medicare Enrollment ID | O20230203000565 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407578263 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
Provider Name | Michael S Colver |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003386525 PECOS PAC ID: 0244663680 Enrollment ID: I20191126000319 |
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