Individual
MR. MARK ALAN FUQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
100 N HOWARD ST STE W, SPOKANE, WA 99201-0508
(615) 852-7816
Mailing address
100 N HOWARD ST STE W, SPOKANE, WA 99201-0508
(256) 777-6717
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
11229
TN
1041C0700X
Clinical Social Worker
Primary
SC61516213
WA
Other
Enumeration date
09/11/2018
Last updated
08/09/2024
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