Provider Demographics
NPI:1861567422
Name:NORTHWEST PEDIATRIC OPHTHALMOLOGY
Entity type:Organization
Organization Name:NORTHWEST PEDIATRIC OPHTHALMOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:N
Authorized Official - Last Name:NYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-838-6686
Mailing Address - Street 1:842 S COWLEY STE 2
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202
Mailing Address - Country:US
Mailing Address - Phone:509-838-6686
Mailing Address - Fax:509-343-5115
Practice Address - Street 1:842 S COWLEY STE 2
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202
Practice Address - Country:US
Practice Address - Phone:509-838-6686
Practice Address - Fax:509-343-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty