Individual
TIMOTHY NEAL CORNWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 W 5TH AVE, SPOKANE, WA 99204
(509) 473-7626
Mailing address
8408 E FLEMING RD, FAIRFIELD, WA 99012-9710
(509) 723-5188
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
RN00168846
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60807265
WA
Other
Enumeration date
10/19/2017
Last updated
06/10/2018
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