Individual
MR. TERRANCE DEVON NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPC
Contact information
Practice address
901 N MONROE ST STE 200, SPOKANE, WA 99201-2148
(509) 715-8302
(509) 241-1866
Mailing address
4102 E FREDERICK AVE, SPOKANE, WA 99217-7063
(509) 638-2236
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CG61250259
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CG61250259
—
WA
Enumeration date
08/15/2022
Last updated
08/15/2022
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