Active NPI
Quinn Marianno
- Athletic Trainer
- Spokane, WA
National Provider Identifier
1134622137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-513
- Practice address
- 605 E Holland Ave Ste 112
Spokane, WA 99218-1246 - Phone
- (509) 342-3251
- Fax
- (509) 342-3280
- NPI assigned
- Mar 15, 2018
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-513 | ID | Primary |
Addresses
Primary practice location
605 E Holland Ave Ste 112
Spokane, WA 99218-1246
Mailing address
605 E Holland Ave Ste 112
Spokane, WA 99218-1246
Phone (509) 342-3251
Other practice location 1
1000 W Garden Ave
Coeur D Alene, ID 83814-2161
Phone (208) 819-0633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160151292 | Other | ID | REGENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-513 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683849600000",
"number": "1134622137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 E HOLLAND AVE STE 112",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992181246",
"telephone_number": "509-342-3251",
"fax_number": "509-342-3280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 E HOLLAND AVE STE 112",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992181246",
"telephone_number": "509-342-3251",
"fax_number": "509-342-3280"
}
],
"practiceLocations": [
{
"address_1": "1000 W Garden Ave",
"address_purpose": "LOCATION",
"city": "Coeur D Alene",
"state": "ID",
"postal_code": "838142161",
"country_code": "US",
"telephone_number": "208-819-0633",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARIANNO",
"first_name": "QUINN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-15",
"last_updated": "2023-05-12",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "AT-513",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "160151292",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.