Provider First Line Business Practice Location Address:
11812 N HIGHWOOD CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-2900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-228-2547
Provider Business Practice Location Address Fax Number:
509-473-9662
Provider Enumeration Date:
01/22/2026