Active NPI
McKenon Victor Abreu, DPM
- Foot & Ankle Surgery Podiatrist
- Spokane Valley, WA
National Provider Identifier
1104519461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- PO70116639
- Practice address
- 12109 E Broadway Ave Ste C
Spokane Valley, WA 99206-6133 - Phone
- (509) 928-1990
- NPI assigned
- Jun 1, 2023
- Last updated
- Aug 20, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO70116639 | WA | Primary |
Addresses
Primary practice location
12109 E Broadway Ave Ste C
Spokane Valley, WA 99206-6133
Mailing address
13802 Jake Rd
Valley Center, CA 92082-5819
Phone (760) 807-0307
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Western Un of HLTH Sciences, Col of Podiatric Med, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
12109 E Broadway Ave
Suite C
Spokane Valley, WA 99206-6133
1214 W Euclid Ave
Spokane, WA 99205-2732
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787184000000",
"number": "1104519461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13802 JAKE RD",
"city": "VALLEY CENTER",
"state": "CA",
"postal_code": "920825819",
"telephone_number": "760-807-0307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12109 E BROADWAY AVE STE C",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992066133",
"telephone_number": "509-928-1990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABREU",
"first_name": "MCKENON",
"middle_name": "VICTOR",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-01",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "WA",
"license": "PO70116639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.