A Community Wellness Clinic LLC
Nurse Practitioner, Family in Spokane, WA. Organization (NPI-2).
NPI number1063056497
StatusActive
Last updated in NPPESMay 13, 2026
Details
- NPI
- 1063056497
- Entity type
- Organization (NPI-2)
- Legal business name
- A Community Wellness Clinic LLC
- Organization subpart
- No
- Enumeration date
- Oct 29, 2019
- Certification date
- May 13, 2026
- Last updated
- May 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
2405 E 17th Ave Ste 113Spokane, WA 99223-5122
Phone 509-720-8516
Mailing address
2405 E 17th Ave Ste 113Spokane, WA 99223-5122
Phone 509-720-8516
Authorized official
Kerry Lee Traugott
Owner
5097208516
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