Provider First Line Business Practice Location Address:
5920 E 9TH 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:
99212-0219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-866-3112
Provider Business Practice Location Address Fax Number:
509-919-4202
Provider Enumeration Date:
03/11/2026