Basic Information
Provider Information
NPI: 1861718611
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VOSS
FirstName: KARLA
MiddleName: MICHELLE
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CLINGER
OtherFirstName: KARLA
OtherMiddleName: M
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
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: 5097556580
Other Information
ProviderEnumerationDate: 04/19/2010
LastUpdateDate: 08/21/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA 60128514WAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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