Individual
JODI W FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2829 S GRAND BLVD, STE 301, SPOKANE, WA 99203
(509) 747-4242
(509) 747-3512
Mailing address
2829 S GRAND BLVD, STE: 301, SPOKANE, WA 99203
(509) 747-4242
(509) 747-3512
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00001693
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5031091
DEPT OF SOCIAL & HEALTH
WA
Enumeration date
11/22/2006
Last updated
07/08/2007
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