Basic Information
| Provider Information | |||||||||
| NPI: | 1548311350 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | URUETA | ||||||||
| FirstName: | WILFRIDO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3649 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 99220 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 W 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992042803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093423758 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 03/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301093328 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD191089 | OR | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 41933 | AZ | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | MD60448377 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.