Individual
CHARLES M DEPNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12012 E MISSION AVE, SPOKANE VALLEY, WA 99206-4887
(509) 413-1630
Mailing address
1310 E 28TH AVE, SPOKANE, WA 99203-3217
(509) 624-9055
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00006099
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8333932
—
WA
Enumeration date
08/04/2009
Last updated
02/17/2011
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