PNW Wound Specialist LLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

PNW WOUND SPECIALIST LLC

Practice address

12925 E Mansfield Ave Apt S106
Spokane Valley, WA 99216-5155

Phone

(509) 701-7014

NPI assigned

Apr 24, 2025

Organization subpart

No

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

Authorized official

Name

Saint Lorenzo

Title

Owner

Phone

(509) 701-7014

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Oldenkamp, M.D.

  • Dermatology Physician
  • Everett, WA
  • NPI 1275669459
  Medicare reassignment NPD
• Julia Ann Taylor, PAC

  • Medical Physician Assistant
  • Spokane, WA
  • NPI 1336248129
  Medicare reassignment
• Vicki Maree Trevino, PA

  • Physician Assistant
  • Spokane, WA
  • NPI 1487658225
  Medicare reassignment

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1497542229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12925 E MANSFIELD AVE APT S106",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992165155",
            "telephone_number": "509-701-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12925 E MANSFIELD AVE APT S106",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992165155",
            "telephone_number": "509-701-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNW WOUND SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "LORENZO",
        "authorized_official_first_name": "SAINT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-701-7014"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Pizzato, LMP
• Planned Parenthood of Greater Washington and North Idaho
• Josiah Plumb
• Daisy Carina Pluskett
• Pneuback Sports & Therapy Institute Northwest LLC
• Alyssa Poffenroth
• Point of Origin Acupuncture PLLC
• Morghan Elizabeth Poirier
• Courtney Polimeni, ARNP
• Karliee Raeanne Polinsky, RDH

• Medical Physician Assistant in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.