Detore, Miranda K

Detore, Miranda K is an individual health care provider with primary practice located at 217 W Cataldo Ave , Spokane WA 99201-2217. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Detore, Miranda K can be contacted via phone (509) 747-6194.

Contact Information

Primary practice address
217 W Cataldo Ave Spokane WA 99201-2217
Phone: (509) 747-6194
Fax: (509) 252-2837
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60610394 Washington

Profile Details

NPI number 1720471774
LBN Legal business name Detore, Miranda K
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2015
Last updated Feb 6th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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