Active NPI
Spence Dee Killian
- Specialist
- Walla Walla, WA
National Provider Identifier
1598051294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- HA 00002210
- Practice address
- 2330 Eastgate North
Suite 101
Walla Walla, WA 99362 - Phone
- (509) 529-2693
- Fax
- (509) 529-9469
- NPI assigned
- Jun 22, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | HA 00002210 | WA | Primary |
Addresses
Primary practice location
2330 Eastgate North
Suite 101
Walla Walla, WA 99362
Mailing address
2330 Eastgate North
Suite 101
Walla Walla, WA 99362
Phone (509) 529-2693
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 |
|---|---|---|---|
| HA 00002210 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hearusa Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1598051294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2330 EASTGATE NORTH",
"address_2": "SUITE 101",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "99362",
"telephone_number": "509-529-2693",
"fax_number": "509-529-9469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2330 EASTGATE NORTH",
"address_2": "SUITE 101",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "99362",
"telephone_number": "509-529-2693",
"fax_number": "509-529-9469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLIAN",
"first_name": "SPENCE",
"middle_name": "DEE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-22",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "HA 00002210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.