Individual
MARCELLA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4202 S REGAL ST, SPOKANE, WA 99223-7738
(509) 789-3800
Mailing address
6014 N RUBY ST APT 31, SPOKANE, WA 99208-1151
(570) 267-5288
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60780256
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL60780256
WA STATE DEPARTMENT OF HEALTH
WA
Enumeration date
05/24/2019
Last updated
05/24/2019
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