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Contact Information

JACQUELYN L BANASIK, MN ARNP
103 E SPOKANE FALLS BLVD
NURS 447
SPOKANE, WA99202
 Phone: 509-324-7269
 Fax: 509-324-7341
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JACQUELYN L BANASIK · (Female)

NPI # 1174518021
Status Active
Credentials MN ARNP
Entity Individual
Enumeration date 09/16/2005
Last updated 05/22/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # AP30003996
  • WA Medicaid 9623026
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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