Individual provider Active NPI

Tamara Garduno, MD

  • Internal Medicine Physician
  • Spokane, WA
National Provider Identifier
1063440766
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00037060 Issued in WA
Practice address
3016 E 57TH Ave
#24
Spokane, WA 99223-7036
Phone
(509) 838-2531
NPI assigned
Jun 29, 2006
Last updated
Nov 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00037060 WA Primary

Addresses

Primary practice location

3016 E 57TH Ave
#24
Spokane, WA 99223-7036

Mailing address

PO Box 3649
Spokane, WA 99220-3649
Phone (509) 838-2531

Other identifiers 3

IdentifierTypeStateIssuer
8246373MedicaidWA
0242680OtherWADEPT OF LABOR AND INDUSTRIES
0242682OtherWADEPT OF LABOR AND INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050924000261 WA Practitioner - Internal Medicine 1658305024 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00037060WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Empire Health Services Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

3016 E 57th Ave
Ste 24
Spokane Valley, WA 99223
Phone (509) 342-3971

2713 N Argonne Rd
Spokane Vly, WA 99212
Phone (509) 342-3980

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1063440766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649",
            "telephone_number": "509-838-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 E 57TH AVE",
            "address_2": "#24",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992237036",
            "telephone_number": "509-838-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDUNO",
        "first_name": "TAMARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00037060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8246373",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR AND INDUSTRIES",
            "identifier": "0242680",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR AND INDUSTRIES",
            "identifier": "0242682",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.