Basic Information
Provider Information
NPI: 1124432505
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DROBNY
FirstName: MICHELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 624 E FRONT AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992022139
CountryCode: US
TelephoneNumber: 5096269900
FaxNumber: 5302242738
Practice Location
Address1: 624 E FRONT AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992022139
CountryCode: US
TelephoneNumber: 5096269900
FaxNumber: 5092277070
Other Information
ProviderEnumerationDate: 06/13/2014
LastUpdateDate: 02/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XOP61098620WAY Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X20A17434CAN Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home