Habtamu D Poage

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

756752 Issued in WA

Practice address

705 S Freya St
Spokane, WA 99202-5238

Phone

(509) 475-0038

NPI assigned

Jan 12, 2024

Last updated

Jan 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1255102620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S FREYA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992025238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S FREYA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992025238",
            "telephone_number": "509-475-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POAGE",
        "first_name": "HABTAMU",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "756752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Borys Pleskacz
• Samuel Joseph Plesner, DO
• Roberta Plunkett
• Jennifer Mary Plymale, M.D.
• PNW Pediatric Therapy, LLC
• William Terry Pochis, M.D.
• Jacquelyn L Poe
• Janet Poe
• Alyssa Poffenroth, LMHCA
• Brayden Birkett Poffenroth, PHARMD

• Adult Care Home Facility in Spokane, WA
• Providers in Spokane, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.