Mainer, Michael Jacks

Mainer, Michael Jacks is an individual health care provider with primary practice located at 3754 W Indian Trail Rd , Spokane WA 99208-4700. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Mainer, Michael Jacks can be contacted via phone (509) 328-7041.

Contact Information

Primary practice address
3754 W Indian Trail Rd Spokane WA 99208-4700
Fax: (509) 328-7582
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD00015454 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00015454 Washington

Profile Details

NPI number 1760435028
LBN Legal business name Mainer, Michael Jacks
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Nov 21st, 2018 - about 6 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 1760435028 NPPES
Washington Other 0195465 WORKERS' COMP
Washington MEDICAID 1105303 WORKERS' COMP
Washington Other P00209862 WORKERS' COMP

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