DACOTAH J SPURGEON (NPI# 1902975097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902975097 |
| Entity Type | Individual |
| Full Name | DACOTAH J SPURGEON |
| Credential | MS PT, PA-C |
| Practice Address |
1114 W 20th Ave Spokane WA 99203-1147 |
| Practice Telephone | 5092303745 |
| Mailing Telephone | 5092303745 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2019-09-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | PT00009166 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8362733 | 05 | |
| WA | LABOR AND INDUSTRY /L&I/ WASHINGTON STATE | 172561 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 622 W 20th Ave, Spokane, WA 992032062 | 5096241018 |
| Street Address |
1114 W 20TH AVE |
| City | SPOKANE |
| State | WA |
| Zip Code | 99203-1147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164992541 | Ashley Thunder Hawk | Massage Therapist | 1001 W 25th Ave # 2, Spokane, WA 99203 | 2018-11-28 |
| 1134612500 | Jill Johnston | Nurse Practitioner | 1418 S Tacoma St, Spokane, WA 99203 | 2018-06-11 |
| 1356731988 | Rebekah Elizabeth Alice | Midwife | 417 E 28th Ave, Spokane, WA 99203 | 2015-02-03 |
| 1295155455 | Jordan Diamond | Dentist | 2204 E 29th Ave Ste 104, Spokane, WA 99203 | 2014-04-25 |
| 1952687386 | Providence Phsyician Services | Family Medicine | 1919 S. Grand Blvd., Spokane, WA 99203 | 2011-10-31 |
| 1033411103 | Patricia Mary Bedalov | Speech-Language Pathologist | 1017 W. 26th Ave., Spokane, WA 99203 | 2010-11-23 |
| 1841591310 | Travis Craig Romney | Chiropractor | 1403 S Grand Blvd., Suite 101s, Spokane, WA 99203 | 2010-11-15 |
| 1942518154 | South Hill Pediatric Dentistry | Dentist | 2020 E 29th Avenue, 130, Spokane, WA 99203 | 2010-09-22 |
| 1942512421 | Judy Lynn Budrow | Massage Therapist | 1805 E. 36th, Spokane, WA 99203 | 2010-07-13 |
| 1871741843 | Elisabeth Carroll Bagby | Massage Therapist | 132 W. 32nd Ave., Spokane, WA 99203 | 2008-09-03 |
| Find all providers in zip 99203 | ||||
| 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 |
| 1750359154 | Terri J Roark | Physician Assistant | 911 W 5th Avenue, Spokane, WA 99204 | 2006-03-10 |
| 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 |
| 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.