Individual
MIRANDA K DETORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
217 W CATALDO AVE, SPOKANE, WA 99201-2217
(509) 747-6194
(509) 252-2837
Mailing address
PO BOX 2242, SPOKANE, WA 99210-2242
(509) 747-6194
(509) 252-2837
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60610394
WA
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
03/16/2015
Last updated
02/06/2024
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