Provider Demographics
NPI:1104529189
Name:SIMPLICITY DIRECT CARE, PLLC
Entity type:Organization
Organization Name:SIMPLICITY DIRECT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:AILEEN
Authorized Official - Last Name:DYGERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-779-8793
Mailing Address - Street 1:3435 S LONDON CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-1655
Mailing Address - Country:US
Mailing Address - Phone:607-343-4675
Mailing Address - Fax:
Practice Address - Street 1:2020 E 29TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3951
Practice Address - Country:US
Practice Address - Phone:509-779-8793
Practice Address - Fax:509-241-9385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care