Organization
CONCRETE ROSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREIANNA MARIE GORDER (EXECUTIVE DIRECTOR)
(206) 866-4213
Entity
Organization
Contact information
Practice address
621 S ADAMS ST APT 6, SPOKANE, WA 99204-3259
(206) 866-4213
Mailing address
621 S ADAMS ST APT 6, SPOKANE, WA 99204-3259
(206) 866-4213
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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