Individual
WILLIAM WISE-GENDUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4815 N ASSEMBLY ST, SPOKANE, WA 99205-6185
(509) 434-7762
Mailing address
5314 W BISMARK AVE, SPOKANE, WA 99208-6296
(509) 434-9696
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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