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Individual

MISS LEESA GUST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
15701 E SPRAGUE AVE, SUITE C, SPOKANE VALLEY, WA 99037-5019
(509) 926-9355
Mailing address
PO BOX 13264, SPOKANE VALLEY, WA 99213-3264
(509) 990-8208

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00024194
WA

Other

Enumeration date
04/01/2010
Last updated
04/01/2010
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