Icenogle, Deborah Ann
Icenogle, Deborah Ann is an individual health care provider with primary practice located at 5011 W Lowell Ave Ste 100 , Spokane WA 99208-8587. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Icenogle, Deborah Ann can be contacted via phone (509) 299-1958.Contact Information
Primary practice address
5011 W Lowell Ave Ste 100
Spokane WA 99208-8587
Phone: (509) 299-1958
Fax: (509) 299-1070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | MD00028918 | Washington |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00028918 | Washington |
Profile Details
| NPI number | 1831296177 |
|---|---|
| LBN Legal business name | Icenogle, Deborah Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 21st, 2022 - about 3 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 | 1831296177 | NPPES |
| Washington | MEDICAID | 1120765 |
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