Provider Demographics
NPI:1780965186
Name:SELKIRK INTERVENTIONAL PAIN PHYSICIANS PLLC
Entity type:Organization
Organization Name:SELKIRK INTERVENTIONAL PAIN PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:MOMANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-723-7999
Mailing Address - Street 1:5901 N LIDGERWOOD ST STE 218
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-1122
Mailing Address - Country:US
Mailing Address - Phone:509-723-7999
Mailing Address - Fax:877-670-2123
Practice Address - Street 1:5901 N LIDGERWOOD ST STE 218
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1122
Practice Address - Country:US
Practice Address - Phone:509-723-7999
Practice Address - Fax:877-670-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027010207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty