Individual provider Active NPI

Douglas Ray Tanner, D.O.

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1063899185
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP60716748 Issued in WA
Practice address
1803 W Maxwell Ave
Spokane, WA 99201
Phone
(509) 483-7535
NPI assigned
Apr 27, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP60716748 WA Primary

Addresses

Primary practice location

1803 W Maxwell Ave
Spokane, WA 99201

Mailing address

1803 W Maxwell Ave
Spokane, WA 99201-2831

Other practice location 1

104 W 5th Ave Ste 200W
Spokane, WA 99204-4803
Phone (509) 624-2313

Other practice location 2

104 W 5th Ave Ste 200W
Spokane, WA 99204-4803
Phone (509) 624-2313

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
I20181024003296 WA Practitioner - Family Practice 2365795184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Native ProjectGroup PAC ID 8921999129, 7 clinicians

Practice addresses (Care Compare)

1803 W Maxwell Ave
Spokane, WA 99201-2831
Phone (509) 483-7535

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP60716748WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Native Project Family Medicine CurrentSince Jul 4, 2018 Accepting new patients

Locations

1803 W Maxwell Ave
Spokane, WA 99201
Phone (509) 325-5502

1803 W Maxwell Ave
Ste 660
Spokane, WA 99201

Interoperability endpoints

  • Direct secure messaging: dtanner@nativeproject.directbygreenway.com
  • Direct secure messaging: dtanner737340@direct.ochin.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1063899185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 W MAXWELL AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 W MAXWELL AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99201",
            "telephone_number": "509-483-7535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 W 5th Ave Ste 200W",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992044803",
            "country_code": "US",
            "telephone_number": "509-624-2313",
            "fax_number": "509-459-0686",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 W 5th Ave Ste 200W",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992044803",
            "country_code": "US",
            "telephone_number": "509-624-2313",
            "fax_number": "509-459-0686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNER",
        "first_name": "DOUGLAS",
        "middle_name": "RAY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60716748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.