Individual
DOMINIC MARCILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO60930415
Contact information
Practice address
312 W 8TH AVE, SPOKANE, WA 99204-2506
(509) 315-9791
Mailing address
312 W 8TH AVE, SPOKANE, WA 99204-2506
(509) 315-9791
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60930415
WA
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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