Mccully, Letitia L

Mccully, Letitia L is an sole proprietor health care provider with primary practice located at 15812 E Indiana Ave , Spokane Valley WA 99216-1875. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mccully, Letitia L can be contacted via phone (509) 444-8200.

Contact Information

Primary practice address
15812 E Indiana Ave Spokane Valley WA 99216-1875
Fax: (509) 444-7806
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10004606 Washington

Profile Details

NPI number 1780613547
LBN Legal business name Mccully, Letitia L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 2nd, 2006
Last updated Apr 12th, 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 1780613547 NPPES
Washington MEDICAID 8388431

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