1497763585 NPI number — DRS. GOLDMAN & SUMMERS, PLLC

Table of content: (NPI 1497763585)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497763585 NPI number — DRS. GOLDMAN & SUMMERS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. GOLDMAN & SUMMERS, PLLC
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:
1497763585
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/25/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9631 N NEVADA ST STE 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99218-1197
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-467-8355
Provider Business Mailing Address Fax Number:
509-467-7151

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9631 N NEVADA ST STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-1197
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-467-8355
Provider Business Practice Location Address Fax Number:
509-467-7151
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHIESA
Authorized Official First Name:
TERESA
Authorized Official Middle Name:
B
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
509-467-8355

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD00020871 , 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: 000010147266 . This is a "REGENCE BLUESHIELD OF IDA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: KW773 . This is a "BLUE CROSS OF IDAHO" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00124645 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 000010147265 . This is a "REGENCE BLUESHIELD OF IDA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00165602 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00240230 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: POO124661 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 7123839 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 163050 . This is a "LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com