Provider First Line Business Practice Location Address:
110 W CLIFF DR
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:
99204-3618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-370-8239
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/27/2026