1366625642 NPI number — ANYA CONSIGLIO MD, PS

Table of content: (NPI 1366625642)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366625642 NPI number — ANYA CONSIGLIO MD, PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANYA CONSIGLIO MD, 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:
1366625642
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
406 E ROWAN AVE
Provider Second Line Business Mailing Address:
SUITE200
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99207-1201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-489-4040
Provider Business Mailing Address Fax Number:
509-489-9190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
406 E ROWAN AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-489-4040
Provider Business Practice Location Address Fax Number:
509-489-9190
Provider Enumeration Date:
12/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CONSIGLIO
Authorized Official First Name:
ANYA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
509-489-4040

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD00048498 , 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: 1366625642 . This is a "NPI CORP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 226211 . This is a "LABOR & INDUSTRY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 4954CO . This is a "ASURIS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8870436 . This is a "MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: DN2383 . This is a "RAILROAD MEDICARE GROUP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00610288 . This is a "RAILROAD MEDICARE- PTAN GROUP MEMBER NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1659458404 . This is a "NPI DOCTOR" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1124569 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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