Basic Information
| Provider Information | |||||||||
| NPI: | 1720613078 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YAHNE | ||||||||
| FirstName: | CAITLIN | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | SCHLEGEL | ||||||||
| OtherFirstName: | CAITLIN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 407 E 2ND AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992021428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094556002 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 407 E 2ND AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992021428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094556002 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2020 | ||||||||
| LastUpdateDate: | 03/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT60366864 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.