| Providence Family Medicine Manito Clinic | |
|
1919 S. Grand Blvd. Spokane WA 99203 | |
| (509) 789-9925 | |
| Not Available |
| Full Name | Providence Family Medicine Manito Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1919 S. Grand Blvd., Spokane, Washington |
| Authorized Official Name and Position | Michael Mallory (CRED. SPECIALIST) |
| Authorized Official Contact | 4255256798 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Family Medicine Manito Clinic Po Box 34439 Seattle WA 98124 Ph: () - | Providence Family Medicine Manito Clinic 1919 S. Grand Blvd. Spokane WA 99203 Ph: (509) 789-9925 |
| NPI Number | 1952687386 |
|---|---|
| Provider Enumeration Date | 10/31/2011 |
| Last Update Date | 10/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952687386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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