Provider Demographics
NPI:1417240961
Name:SPENDLOVE, SCOTT P (DO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:P
Last Name:SPENDLOVE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8524 W GAGE BLVD
Mailing Address - Street 2:BLDG A1 BOX 319
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-8241
Mailing Address - Country:US
Mailing Address - Phone:509-591-0070
Mailing Address - Fax:509-396-9661
Practice Address - Street 1:1414 N VERCLER RD STE 5
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1092
Practice Address - Country:US
Practice Address - Phone:206-538-6300
Practice Address - Fax:206-538-6301
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60640664207L00000X, 207LP2900X, 208VP0014X
IDO-1293208VP0014X
TXP9464207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2064650Medicaid
TX349814902OtherCSHCN
TX349814901Medicaid
WA2064650Medicaid
TX349814901Medicaid