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
Fax: (509) 456-5902
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164561569 NPPES
Washington MEDICAID 8332652

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