Individual
ALVA JACK CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 W 8TH AVE, SUITE 1100, SPOKANE, WA 99204-2307
(509) 474-4060
(509) 474-6198
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD114350
MO
207V00000X
Obstetrics & Gynecology Physician
Primary
MD60096557
WA
Other
Enumeration date
07/18/2005
Last updated
05/03/2021
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