Provider Demographics
NPI:1609890243
Name:INLAND ORTHOPAEDICS OF SPOKANE PS
Entity type:Organization
Organization Name:INLAND ORTHOPAEDICS OF SPOKANE PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:G
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-838-7100
Mailing Address - Street 1:820 S MCCLELLAN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2457
Mailing Address - Country:US
Mailing Address - Phone:509-838-7100
Mailing Address - Fax:509-838-0721
Practice Address - Street 1:820 S MCCLELLAN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2457
Practice Address - Country:US
Practice Address - Phone:509-838-7100
Practice Address - Fax:509-838-0721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00013680261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7071574Medicaid
WA319206900Medicare PIN