SPORT & SPINE LLC (NPI# 1376097279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376097279 |
| Entity Type | Organization |
| Organization Name | SPORT & SPINE LLC |
| Other Organization Name | SPOKANE SPORT & SPINE |
| Practice Address |
3209 E 57th Ave Ste F Spokane WA 99223-7040 |
| Mailing Address |
5428 S Regal St Po Box 31032 Spokane WA 99223-8153 |
| Practice Telephone | 5097201117 |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |
| Authorized Official Name | DR. RYAN D JOHNSON (DOCTOR OF CHIROPRACTIC) |
| Authorized Official Telephone | 5097201117 |
| Authorized Official Credential | DC, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | CH60130771 | WA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Spokane Sport & Spine | Doing Business As Name - Organization |
| Street Address |
3209 E 57TH AVE STE F |
| City | SPOKANE |
| State | WA |
| Zip Code | 99223-7040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356502801 | Anna Marie Wetzler | Massage Therapist | 3209 E 57th Ave, Suite F, Spokane, WA 99223-7040 | 2008-06-18 |
| 1679087258 | Lindsey Dulyea | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223-7040 | 2017-11-19 |
| 1164931507 | Kirsten Etta Larson | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223 | 2017-09-28 |
| 1518497775 | Rebecca Ray Mischel | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223-7040 | 2017-06-19 |
| 1275066672 | Timothy Martinchuk | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223-7040 | 2017-04-04 |
| 1225579220 | Kayden Gilmore | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223-7040 | 2017-03-10 |
| 1114468162 | Shelby Mears | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223-7040 | 2017-03-10 |
| 1710338777 | Naomi Judy Moran | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223-7040 | 2016-06-30 |
| 1568834968 | Kelly Dawn Ayers | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223-7040 | 2015-10-24 |
| 1932582392 | Jennifer Oniu | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223-7040 | 2015-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790253110 | The Anna Schindler Foundation Inc | Lodging | 2322 E 28th Ave, Spokane, WA 99223 | 2018-11-03 |
| 1174018113 | Taylor Bryant Etchart | Massage Therapist | 7040, 3209 E 57th Ave, Suite H, Spokane, WA 99223 | 2018-06-22 |
| 1366958415 | Jennifer Andrea Meroshnik | Massage Therapist | 3210 East 44th Ave, F301, Spokane, WA 99223 | 2017-12-26 |
| 1982060539 | Andrew John David Bingham | Nurse's Aide | 4202 S Regal St, Spokane, WA 99223 | 2016-01-12 |
| 1396118469 | Kerry Lee Traugott | Nurse Practitioner | 2405 E 17th Ave, Suite 113, Spokane, WA 99223 | 2015-11-11 |
| 1518335082 | Thomas Genthe | Psychologist | 5619 South Custer Rd., Spokane, WA 99223 | 2015-09-14 |
| 1346630035 | Inland Empire Therapy Associates | Occupational Therapist | 2527 E. 27th, Suite 100, Spokane, WA 99223 | 2015-02-02 |
| 1396080743 | Karin Lee Gilchrist | Dietitian, Registered | 3019 S. Lloyd Lane, Spokane, WA 99223 | 2012-12-11 |
| 1184968752 | Susan Marie Reynolds | Massage Therapist | 3010 S. Southeast Blvd, Suite A, Spokane, WA 99223 | 2012-11-20 |
| 1750638110 | Bobby E Kizer | Psychologist | 4219 E Prairie Lane Ct, Spokane, WA 99223 | 2012-08-04 |
| Find all providers in zip 99223 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801350350 | Ideal Option, Pllc | Clinic/Center | 901 N Monroe St Ste 322, Spokane, WA 99201-2148 | 2019-01-29 |
| 1679087043 | Amw Wellness LLC | Clinic/Center | 906 W 2nd Ave Fl 6, Spokane, WA 99201-4538 | 2017-11-21 |
| 1629319850 | Institute Medical Services, LLC | Clinic/Center | 10 N Post St, Spokane, WA 99201-0712 | 2013-03-13 |
| 1639357940 | Edward L Charbonneau, Dds | Clinic/Center | 1520 W Garland Ave, Spokane, WA 99205-2613 | 2008-02-08 |
| 1730378308 | D. Todd Wylie, O.d., Inc. | Clinic/Center | 104 S Freya Street, Suite 220, White Flag Bldg, Spokane, WA 99202-4867 | 2007-10-19 |
| 1457958530 | Metta Wellness Nw Pllc | Clinic/Center | 904 W Riverside Ave Unit 1107, Spokane, WA 99210-0329 | 2020-10-02 |
| 1770074965 | Inland Northwest Health Services | Clinic/Center | 501 N Riverpoint Blvd Ste 245, Spokane, WA 99202-1649 | 2018-05-23 |
| 1306391446 | Providence Health & Services Washington | Clinic/Center | 2923 E 29th Ave, Spokane, WA 99223-4811 | 2016-08-18 |
| 1396143319 | Inkare, LLC | Clinic/Center | 611 E 2nd Ave, Suite B, Spokane, WA 99202-6010 | 2014-12-07 |
| 1548674872 | Douglas W. Lyman, Od, Pllc | Clinic/Center | 7619 N Division St, Spokane, WA 99208-5613 | 2014-06-14 |
| Find all providers in SPOKANE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.