Spokane Ent Clinic Mayfair
NPI #1033154273 in Spokane, Washington
Provider Information
- NPI Number
- 1033154273
- Entity Type
- Organization
- Organization Name
- Spokane Ent Clinic Mayfair
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Jun 20, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 5901 N MAYFAIR ST
- City
- Spokane
- State
- Washington
- ZIP Code
- 99208-5096
- Phone
- (509) 489-3514
Authorized Official
- Name
- DIRENDIA SHACKELFORD
- Title
- MANAGED CARE SPECIALIST
- Phone
- (800) 654-0889
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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