TERRI J ROARK (NPI# 1750359154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750359154 |
| Entity Type | Individual |
| Full Name | TERRI J ROARK |
| Credential | PA-C |
| Practice Address |
911 W 5th Avenue Spokane WA 99204 |
| Mailing Address |
Po Box 8500 Lockbox 7642 Philadelphia PA 19178-7642 |
| Practice Telephone | 5094557844 |
| Practice Fax Number | 5096230415 |
| Mailing Telephone | (813) 281-8115 |
| Mailing Fax Number | 8132818656 |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2017-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10003201 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | RR MEDICARE | P00393503 | 01 |
| WA | LICENSE | PA10003201 | 01 |
| Street Address |
911 W 5TH AVENUE |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285961854 | Kari Marie Holman | Physician Assistant | 911 W 5th Avenue, Spokane, WA 99204 | 2009-11-03 |
| 1952581589 | Kathryn S. Doughty | Orthopaedic Surgery | 911 W 5th Avenue, Spokane, WA 99204 | 2007-11-12 |
| 1679778641 | Patricia E Michels | Anesthesiology | 911 W 5th Avenue, Spokane, WA 99204 | 2007-06-19 |
| 1932312642 | Tiffany Lane Bartsch | Anesthesiology | 911 W 5th Avenue, Spokane, WA 99204 | 2007-05-08 |
| 1871642611 | Melanie Sanborn | Pediatrics | 911 W 5th Avenue, Spokane, WA 99204 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104273648 | Grant Bursell | Physician Assistant | 5316 E Sumac Ln, Spokane, WA 99223-5090 | 2016-05-14 |
| 1881093904 | Jacob Gott | Physician Assistant | 122 W 7th Ave Ste 420, Spokane, WA 99204-2330 | 2014-08-14 |
| 1235215856 | Kurt D Fullmer | Physician Assistant | 406 E Rowan Ave, Suite200, Spokane, WA 99207-1243 | 2006-10-27 |
| 1689782740 | Lori Tschetter | Physician Assistant | 42 E Rowan Ave Ste A, Spokane, WA 99207-1212 | 2006-08-29 |
| 1316973498 | Daniel Ray Keele | Physician Assistant | 4815nwassembly, Spokane, WA 99205 | 2006-06-23 |
| 1386606093 | Kathleen Elizabeth Moudy | Physician Assistant | 9911 N Nevada St, Spokane, WA 99218-1298 | 2006-04-06 |
| 1942289392 | Mara Lea Geffken | Physician Assistant | 605 E Holland, Suite 218, Spokane, WA 99218-1246 | 2006-01-13 |
| 1285611665 | Amy M Gregg | Physician Assistant | 105 W 8th, Spokane, WA 99204-2304 | 2005-12-28 |
| 1215913850 | Marc A. Hawkins | Physician Assistant | 310 N Riverpoint Blvd Health Science Bldg #280-j, University of Washington Medex Nw Pa Program, Spokane, WA 99202 | 2005-12-15 |
| 1487210878 | Devon Graves | Physician Assistant | 62 W 7th Ave Ste 450, Spokane, WA 99204 | 2019-05-12 |
| 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.