Individual
MECQUE FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 S UNIVERSITY RD STE 101, SPOKANE VALLEY, WA 99206-6164
(509) 921-9798
Mailing address
325 S UNIVERSITY RD STE 101, SPOKANE VALLEY, WA 99206-6164
(509) 921-9798
(509) 921-9774
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60059345
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT60059345
LICENSE
WA
Enumeration date
01/28/2020
Last updated
01/28/2020
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