Individual provider Active NPI

McKenon Victor Abreu, DPM

  • Foot & Ankle Surgery Podiatrist
  • Spokane Valley, WA
National Provider Identifier
1104519461
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO70116639 Issued in WA
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, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

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

Verify at the official NPI Registry.