1609957984 NPI number — OB/GYN ASSOCIATES OF SPOKANE, PS

Table of content: VONANIQUIA TEIARA JONES (NPI 1316602535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609957984 NPI number — OB/GYN ASSOCIATES OF SPOKANE, PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OB/GYN ASSOCIATES OF SPOKANE, PS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609957984
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 W 5TH AVE
Provider Second Line Business Mailing Address:
SUITE #301
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99204-2705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-455-8866
Provider Business Mailing Address Fax Number:
509-838-3411

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 W 5TH AVE
Provider Second Line Business Practice Location Address:
SUITE #301
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-8866
Provider Business Practice Location Address Fax Number:
509-838-3411
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RICHARDS
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
JOEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
509-455-8866

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: K2665 . This is a "GROUP NUMBER" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 7036577 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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