Basic Information
Provider Information
NPI: 1639468697
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KEECH
FirstName: AMY
MiddleName: MARIE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3649
Address2:  
City: SPOKANE
State: WA
PostalCode: 992203649
CountryCode: US
TelephoneNumber: 5098382531
FaxNumber: 5097556580
Practice Location
Address1: 400 E 5TH AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992021334
CountryCode: US
TelephoneNumber: 5098382531
FaxNumber: 5097556528
Other Information
ProviderEnumerationDate: 03/30/2011
LastUpdateDate: 12/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/12/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000XMD2014-0591NMN Allopathic & Osteopathic PhysiciansHospitalist 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207Q00000XMD61011219WAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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