| Southgate | |
|
5620 S Regal St Ste 11 Spokane WA 99223-7957 | |
| (509) 444-8888 | |
| (509) 444-7806 |
| Full Name | Southgate |
|---|---|
| Speciality | Clinic/Center |
| Location | 5620 S Regal St Ste 11, Spokane, Washington |
| Authorized Official Name and Position | Aaron Wilson (CEO) |
| Authorized Official Contact | 5094448888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southgate 731 N Iron Bridge Way Spokane WA 99202-4926 Ph: (509) 444-8888 | Southgate 5620 S Regal St Ste 11 Spokane WA 99223-7957 Ph: (509) 444-8888 |
| NPI Number | 1407067317 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 07/31/2026 |
| Certification Date | 07/31/2026 |
| Medicare PECOS PAC ID | 9638063217 |
|---|---|
| Medicare Enrollment ID | O20190109001688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407067317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Washington) | Primary |
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