Individual
BROOKE S TABACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
982 E COLUMBIA AVE STE 201, COLVILLE, WA 99114-3316
(509) 685-5000
Mailing address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 684-5286
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61040497
WA
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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