Individual
JERIC-KAI DASALLA BONGOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
731 N IRON BRIDGE WAY, SPOKANE, WA 99202-4926
(509) 444-8888
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/19/2025
Last updated
03/19/2025
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