Individual
LICENNA MICHELLE BOUIT DUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
800 W 5TH AVE, SPOKANE, WA 99204-2803
(509) 603-5800
Mailing address
910 W 5TH AVE STE 900, SPOKANE, WA 99204-2948
(916) 622-2464
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
PA.61673586
WA
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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