Individual
DR. GARY L PERCIVAL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
800 W SURVIVAL LOOP, BUILDING 1255, FAIRCHILD AFB, WA 99011-8680
(509) 247-9714
Mailing address
11123 E 8TH AVE, SPOKANE VALLEY, WA 99206-5518
(509) 891-7713
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
317398-2501
UT
Other
Enumeration date
03/27/2006
Last updated
07/08/2007
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