Basic Information
| Provider Information | |||||||||
| NPI: | 1194014589 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DE BARROS | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | ALFONSO | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.N.,B.S. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 611 N IRON BRIDGE WAY | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992024932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094448888 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1313 N ATLANTIC ST STE 1500 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992012338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094448200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2011 | ||||||||
| LastUpdateDate: | 05/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 05/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0807X | 64777 | NV | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Child & Adolescent | 163W00000X | 64777 | NV | N | Nursing Service Providers | Registered Nurse | 163WP0807X | RN60732760 | WA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Child & Adolescent | 163WP0808X | 64777 | NV | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 163W00000X | RN60732760 | WA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.