| Providence Medical Group Hawthorne | |
|
551 E Hawthorne Rd Spokane WA 99218-1417 | |
| (509) 252-1900 | |
| (509) 465-4105 |
| Full Name | Providence Medical Group Hawthorne |
|---|---|
| Speciality | Family Medicine |
| Location | 551 E Hawthorne Rd, Spokane, Washington |
| Authorized Official Name and Position | Katlyn Lee (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5094747159 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Hawthorne Po Box 34439 Seattle WA 98124-1439 Ph: (509) 474-2072 | Providence Medical Group Hawthorne 551 E Hawthorne Rd Spokane WA 99218-1417 Ph: (509) 252-1900 |
| NPI Number | 1023394210 |
|---|---|
| Provider Enumeration Date | 11/01/2011 |
| Last Update Date | 11/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023394210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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