Individual
REBECCA MALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-3260
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 474-3260
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60171778
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RES000
MEDICAL LICENSE
WA
Enumeration date
05/16/2008
Last updated
04/03/2017
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