Individual
CORI R LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
19 N 7TH AVE, CHENEY, WA 99004
(509) 838-2531
Mailing address
PO BOX 3649, SPOKANE, WA 99220-3649
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00002115
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
221693
L&I
WA
05
—
8483364
—
WA
Enumeration date
05/02/2007
Last updated
12/12/2008
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