OrganizationActive
A Community Wellness Clinic LLC
NPI 1063056497 · Family Nurse Practitioner · Spokane, WA
Provider details
- NPI number
- 1063056497
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Kerry Traugott, Owner(509) 720-8516
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2405 E 17th Ave Ste 113
Spokane, WA 99223-5122
Phone: (509) 720-8516
Approximate (ZIP-level) locationGet directions
Mailing address
2405 E 17th Ave Ste 113
Spokane, WA 99223-5122
Registry dates
- Enumerated
- 2019-10-29
- Last updated
- 2026-05-13
- Certified
- 2026-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.