Organization Name:  INLAND NORTHWEST SURGERY CENTER PLLC


Practice Location:
526 N MULLAN RD SUITE A & B SPOKANE VALLEY, WA 99206 US
Tel: 509-924-2600  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	213E00000X	Podiatric Medicine & Surgery Service Providers Podiatrist	WA	P000000388
N	213E00000X	Podiatric Medicine & Surgery Service Providers Podiatrist	WA	P000000698
N	261QA1903X	Ambulatory Health Care Facilities Clinic/Center	WA	6011706837
Y	213E00000X	Podiatric Medicine & Surgery Service Providers Podiatrist	WA	P000000333

Other Provider Identifiers:

Issuer	Number	State	Type
LABOR INDUSTRIES	0143764	WA	01
	7127533	WA	05
RAIL ROAD MEDICARE	DD3019	WA	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin