OrganizationActive
Craig C Ellsworth DDS Inc
NPI 1043635543 · Preferred Provider Organization · Spokane Valley, WA
Provider details
- NPI number
- 1043635543
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Craig Ellsworth, President(509) 924-1580
- License
- DE60390327 (WA)
Specialties & taxonomies
Managed Care Organizations
Practice location
12209 E. Mission Ave Suite 1
Spokane Valley, WA 99206
Phone: (509) 924-1580
Fax: (509) 342-7890
Approximate (ZIP-level) locationGet directions
Mailing address
12209 E. Mission Ave Suite 1
Spokane Valley, WA 99206
Registry dates
- Enumerated
- 2014-02-20
- Last updated
- 2026-02-03
- Certified
- 2026-02-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.