Provider Demographics
NPI:1871625855
Name:JUDY FELGENHAUER, M.D., P.S.
Entity type:Organization
Organization Name:JUDY FELGENHAUER, M.D., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:FELGENHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CPAM
Authorized Official - Phone:509-456-0882
Mailing Address - Street 1:PO BOX 8066
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-0066
Mailing Address - Country:US
Mailing Address - Phone:509-456-0882
Mailing Address - Fax:509-455-9948
Practice Address - Street 1:101 W 8TH AVE
Practice Address - Street 2:PEDIARTIC ONCOLOGY CLINIC
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2307
Practice Address - Country:US
Practice Address - Phone:509-456-0882
Practice Address - Fax:509-455-9948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7125846Medicaid