Provider Demographics
NPI:1306842596
Name:MACPHERSON, VINETTA A (ARNP)
Entity type:Individual
Prefix:
First Name:VINETTA
Middle Name:A
Last Name:MACPHERSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 W MAXWELL
Mailing Address - Street 2:NATIVE HEALTH OF SPOKANE
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201
Mailing Address - Country:US
Mailing Address - Phone:509-483-7535
Mailing Address - Fax:509-487-7155
Practice Address - Street 1:1803 W MAXWELL
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201
Practice Address - Country:US
Practice Address - Phone:509-483-7535
Practice Address - Fax:509-487-7155
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003681363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9620659Medicaid
WAAB29661Medicare ID - Type Unspecified
WA9620659Medicaid
P61128Medicare UPIN
WI501895Medicare Oscar/Certification