Provider Demographics
NPI:1124685045
Name:LINER, JOHNNY EDWARD (NP)
Entity type:Individual
Prefix:
First Name:JOHNNY
Middle Name:EDWARD
Last Name:LINER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:522 W RIVERSIDE AVE STE 4115
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0580
Mailing Address - Country:US
Mailing Address - Phone:509-495-1810
Mailing Address - Fax:509-505-0806
Practice Address - Street 1:16201 E INDIANA AVE STE 3260
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2846
Practice Address - Country:US
Practice Address - Phone:509-495-1810
Practice Address - Fax:509-505-0806
Is Sole Proprietor?:No
Enumeration Date:2019-05-27
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP141227363LP2300X
ID65670363LP2300X
WAAP60930259363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care