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Organization
CUP OF COOL WATER
Active
Organization
CUP OF COOL WATER
Active
Other names
CUP OF COOL WATER
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE RANDOLPH WALTMAN (EXECUTIVE DIRECTOR)
(509) 747-6686
Entity
Organization
Contact information
Practice address
1106 W 2ND AVE, SPOKANE, WA 99201-4506
(509) 747-6686
Mailing address
1106 W 2ND AVE, SPOKANE, WA 99201-4506
(509) 747-6686
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
03/16/2022
Last updated
03/16/2022
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