Individual
DR. EDWIN ANDRE DE KOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
235 E. ROWAN AVE, SUITE 202, SPOKANE, WA 99207
(503) 252-1905
Mailing address
235 E. ROWAN AVE, SUITE 202, SPOKANE, WA 99207
(530) 953-7740
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
160835
CA
2083X0100X
Occupational Medicine Physician
MD.MD.61124604
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2017
Last updated
07/09/2021
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