1790142701 NPI number — KIRK FUHRIMAN PLLC

Table of content: (NPI 1790142701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790142701 NPI number — KIRK FUHRIMAN PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KIRK FUHRIMAN 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:
6
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:
1790142701
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9302 N COLTON ST
Provider Second Line Business Mailing Address:
SUITE #100
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99218-1290
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-863-9460
Provider Business Mailing Address Fax Number:
509-868-0428

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9302 N COLTON ST
Provider Second Line Business Practice Location Address:
SUITE #100
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-1290
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-863-9460
Provider Business Practice Location Address Fax Number:
509-868-0428
Provider Enumeration Date:
01/21/2016

Additional Information

Authorized Official

Authorized Official Last Name:
FUHRIMAN
Authorized Official First Name:
KIRK
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
509-863-9460

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DE00010409 , 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: 2001636 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com