Individual
MR. JESSE CARROLL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CCC/SLP
Contact information
Practice address
1526 E 7TH AVE, SPOKANE, WA 99202-5510
(509) 473-9672
Mailing address
1526 E 7TH AVE, SPOKANE, WA 99202-5510
(509) 473-9672
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL 00003312
WA
235Z00000X
Speech-Language Pathologist
SLP-1788
ID
Other
Enumeration date
04/15/2009
Last updated
04/15/2009
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