A COMMUNITY WELLNESS CLINIC LLC
NPI 1063056497
Nurse Practitioner - Family in Spokane, WA

Q: What is A Community Wellness Clinic LLC's NPI number?

The NPI number for A Community Wellness Clinic LLC is 1063056497. It was assigned to this organization in the NPPES registry on October 29, 2019.

Q: What is A Community Wellness Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since October 29, 2019

2405 E 17TH AVE STE 113, SPOKANE, WA 99223(509) 720-8516 Get Directions Write a Review

NPPES record last updated: May 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 13, 2026, Dec 22, 2025, Oct 29, 2019 (3 updates tracked since 2019).

On this page

About A Community Wellness Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

A COMMUNITY WELLNESS CLINIC LLC (NPI 1063056497) is a healthcare organization registered as a family in Spokane, Washington and active in the NPI registry since October 2019. The organization lists Kerry Lee Traugott, Owner, as its authorized official.

NPPES Registry Identity

NPI1063056497

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameA COMMUNITY WELLNESS CLINIC LLC

Location Address2405 E 17TH AVE STE 113Spokane, WA 99223-5122

Mailing Address2405 E 17th Ave Ste 113Spokane, WA 99223-5122 · (509) 720-8516

Phone(509) 720-8516

Organization SubpartNo

Authorized OfficialKerry Lee TraugottOwner · (509) 720-8516

Enumeration DateOctober 29, 2019

Last NPPES UpdateMay 13, 20263 updates tracked since enumeration

NPPES CertifiedMay 13, 2026

✔ NPI 1063056497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

2405 E 17TH AVE STE 113, Spokane, WA 99223

Open in Google Maps ↗

Other Identifiers 1

Other1396118469Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is A Community Wellness Clinic LLC's NPI number?

The NPI number for A Community Wellness Clinic LLC is 1063056497. It was assigned to this organization in the NPPES registry on October 29, 2019.

Where is A Community Wellness Clinic LLC located?

A Community Wellness Clinic LLC is located at 2405 E 17th Ave Ste 113, Spokane, WA 99223. The listed phone number is (509) 720-8516.

What is A Community Wellness Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

What insurance does A Community Wellness Clinic LLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list A Community Wellness Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for A Community Wellness Clinic LLC was last updated on May 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.