Basic Information
| Provider Information | |||||||||
| NPI: | 1598128670 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DURRANCE | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | JESSE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7901 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | ELMHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113731329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183343122 | ||||||||
| FaxNumber: | 7183346124 | ||||||||
| Practice Location | |||||||||
| Address1: | 9631 N NEVADA ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992181193 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094653919 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2016 | ||||||||
| LastUpdateDate: | 08/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD61309720 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 301785 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.