Individual
MRS. CLAIR BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-2400
Mailing address
2990 E GOTHAM BAY RD, HARRISON, ID 83833-7821
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00018799
WA
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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