Provider Demographics
NPI:1215358841
Name:ROSS, SELINA MARIE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:SELINA
Middle Name:MARIE
Last Name:ROSS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9631 N NEVADA ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1197
Mailing Address - Country:US
Mailing Address - Phone:509-319-2430
Mailing Address - Fax:877-568-2402
Practice Address - Street 1:9631 N NEVADA ST STE 210
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1197
Practice Address - Country:US
Practice Address - Phone:509-319-2430
Practice Address - Fax:877-568-2402
Is Sole Proprietor?:No
Enumeration Date:2013-12-28
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60417500363LF0000X
WAAP 60417500363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health