Fenton, Jeff Gordon
Fenton, Jeff Gordon is an individual health care provider with primary practice located at 2507 E 27Th Ave , Spokane WA 99223-4908. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Fenton, Jeff Gordon can be contacted via phone (509) 456-6917.Contact Information
Primary practice address
2507 E 27Th Ave
Spokane WA 99223-4908
Phone: (509) 456-6917
Fax: (509) 456-5902
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 5460 | Washington |
Profile Details
| NPI number | 1164561569 |
|---|---|
| LBN Legal business name | Fenton, Jeff Gordon |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 5th, 2007 |
| Last updated | Nov 28th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164561569 | NPPES |
| Washington | MEDICAID | 8332652 |
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