Provider First Line Business Practice Location Address:
17622 E DESMET 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:
99016-5362
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-329-9203
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/30/2026