Provider First Line Business Practice Location Address:
1718 W YORK 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:
99205-3663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-731-4846
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2026