Provider Demographics
NPI:1366764284
Name:TENNICAN, PATRICK O'MALLEY (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:O'MALLEY
Last Name:TENNICAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:665 N. RIVERPOINT BLVD.
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1665
Mailing Address - Country:US
Mailing Address - Phone:509-994-4423
Mailing Address - Fax:509-443-7036
Practice Address - Street 1:665 N. RIVERPOINT BLVD.
Practice Address - Street 2:SUITE 410
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1665
Practice Address - Country:US
Practice Address - Phone:509-994-4423
Practice Address - Fax:509-443-7036
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD 00011313207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease