Basic Information
Provider Information
NPI: 1114691748
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARRETT
FirstName: DEANNA
MiddleName: HOYT
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7723 N MORTON ST
Address2:  
City: SPOKANE
State: WA
PostalCode: 992083973
CountryCode: US
TelephoneNumber: 6199945349
FaxNumber:  
Practice Location
Address1: 212 E CENTRAL AVE STE 240
Address2:  
City: SPOKANE
State: WA
PostalCode: 992086597
CountryCode: US
TelephoneNumber: 5094558820
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/06/2021
LastUpdateDate: 08/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP61212026WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home