Wandermere Occupational Medicine PLLC

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

License

PA10001774 Issued in WA

Legal business name

WANDERMERE OCCUPATIONAL MEDICINE PLLC

Practice address

309 E Farwell Rd
Suite204
Spokane, WA 99218-8210

Phone

(509) 720-7452

Fax

(509) 466-4798

NPI assigned

May 22, 2015

Last updated

Oct 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel J Depner, PA-CNPI 1851492771

Title

Clinic Director

Phone

(509) 879-0039

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel J Depner, PA-C

  • Physician Assistant
  • Spokane, WA
  • NPI 1851492771
  NPD (past) Authorized official

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1295114346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 W ALCOTT CT",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992089141",
            "telephone_number": "509-879-0039",
            "fax_number": "509-466-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E FARWELL RD",
            "address_2": "SUITE204",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992188210",
            "telephone_number": "509-720-7452",
            "fax_number": "509-466-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANDERMERE OCCUPATIONAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "DEPNER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "509-879-0039",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "WA",
            "license": "PA10001774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walton's Family Therapies
• Jon Montgomery Wamba, DDS
• Wams Nursing Services LLC
• Wams Serene Afh LLC
• Wandermere Family Medicine LLC
• Jodie L Waner, L.M.P.
• Joseph M. Waner, CPD, NCAC, CDCC III
• Jing Wang, RP
• Valerie Bastian Wang, P.T.
• George Wangai, PMHNP

• Occupational Medicine Clinic/Center in Spokane, WA
• Providers in Spokane, WA by specialty
• Occupational Medicine Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.