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92D MEDGRP-FAIRCHILD
NPI 1104888288
Clinic/Center - Military/U.S. Coast Guard Outpatient in Fairchild Afb, WA

Active since April 04, 2006
701 HOSPITAL LOOP, FAIRCHILD AFB, WA 99011(509) 247-9264(509) 247-3535 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 17, 2025, Jun 12, 2025 (2 updates tracked since 2025).

About 92d Medgrp-fairchild NPPES

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

92D MEDGRP-FAIRCHILD (NPI 1104888288) is a healthcare organization registered as a military/u.s. coast guard outpatient in Fairchild Afb, Washington and active in the NPI registry since April 2006. The organization lists Jen Lewandowski, Dha Ubo, as its authorized official.

NPPES Registry Identity

NPI1104888288
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business Name92D MEDGRP-FAIRCHILD
Location Address701 HOSPITAL LOOPFairchild Afb, WA 99011-8704
Mailing Address701 Hospital LoopFairchild Afb, WA 99011-8704 · (509) 247-9264 · Fax (509) 247-3535
Phone(509) 247-9264
Fax(509) 247-3535
Organization SubpartYes
Authorized OfficialJen LewandowskiDha Ubo · (703) 817-4030
Enumeration DateApril 4, 2006
Last NPPES UpdateJune 17, 20252 updates tracked since enumeration
NPPES CertifiedJune 17, 2025
✔ NPI 1104888288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities
Taxonomy Code261QM1100X
Definition
The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
Also ListedClinic/Center · Military and U.S. Coast Guard Ambulatory ProcedureTaxonomy 261QM1101X
Also ListedMilitary/U.S. Coast Guard PharmacyTaxonomy 332000000X
701 HOSPITAL LOOP, Fairchild Afb, WA 99011
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Other Names 1

Other NameFairchild Afb Mtf

Other Identifiers 1

Other49-24507WA · Ncpdp

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CINDY T FINKE ARNP
Nurse Practitioner
701 HOSPITAL LOOP
FAIRCHILD AFB, WA 99011
Spokane County (509) 247-5661
DR. CARRIE L LUCAS
Social Worker (Clinical)
701 HOSPITAL LOOP
FAIRCHILD AFB, WA 99011
Spokane County (509) 247-2361
DR. MAI LIEN PHAM D.O
Internal Medicine
701 HOSPITAL LOOP
FAIRCHILD AIR FORCE BASE, WA 99011
Spokane County (509) 247-5755
DANIEL MICHAEL NORMANDIN PA-C
Physician Assistant
701 HOSPITAL LOOP
FAIRCHILD AFB, WA 99011
Spokane County (509) 247-5661
ROBERT DEANE BOLTON M.D.
Pediatrics
701 HOSPITAL LOOP
FAIRCHILD AFB, WA 99011
Spokane County (509) 247-9043
JAMES SCOT FITE FNP-BC
Nurse Practitioner (Family)
701 HOSPITAL LOOP
FAIRCHILD AFB, WA 99011
Spokane County (509) 247-2361
ALYSE MARIE CARLSON M.D.
Pediatrics
701 HOSPITAL LOOP
FAIRCHILD AFB, WA 99011
Spokane County (247) 509-9898
CATHERINE RAMIG
Nurse Practitioner (Family)
701 HOSPITAL LOOP
FAIRCHILD AFB, WA 99011
Spokane County (509) 247-5755

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 92D Medgrp-Fairchild's NPI number?

The NPI number for 92D Medgrp-Fairchild is 1104888288. It was assigned to this organization in the NPPES registry on April 4, 2006. The provider is also known as Fairchild AFB MTF.

Where is 92D Medgrp-Fairchild located?

92D Medgrp-Fairchild is located at 701 Hospital Loop, Fairchild Afb, WA 99011. The listed phone number is (509) 247-9264.

What is 92D Medgrp-Fairchild's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

When was this NPI record last updated?

The NPPES record for 92D Medgrp-Fairchild was last updated on June 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.