Individual
DR. EDWARD L DEATHERAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5814 S THISTLE LN, SPOKANE, WA 99223-1702
(208) 651-0179
(208) 651-0179
Mailing address
5814 S THISTLE LN, SPOKANE, WA 99223-1702
(208) 651-0179
(208) 651-0179
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00000714
WA
Other
Enumeration date
12/19/2006
Last updated
06/21/2016
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