Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Sergei Borisovich Ivanov, MD

Individual provider Internal Medicine Physician · NPI 1457732950

Dr. Sergei Borisovich Ivanov, MD is an Internal Medicine in Spokane, Washington. Qualified in 2017, 9 years ago. Practices with Providence Health and Services Washington, a 776-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
9
Licensed in
WA
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

62 W 7th Ave Ste 320
Spokane, WA 99204-2321
Phone: (509) 381-6505
Fax: (509) 227-7070
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD61120400 (WA)

Record details

NPI number1457732950
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 11, 2015
Last updated in NPPESNovember 28, 2023
Certification dateNovember 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Providence Health And Services Washington — 776 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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