Provider First Line Business Practice Location Address:
49 W 34TH AVE
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:
99203-1614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-998-7522
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2026