Provider First Line Business Practice Location Address:
10425 E 48TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206-9214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-489-2433
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2026