Individual
DWIGHT AUSTIN SERGIO DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP61215033
Contact information
Practice address
1302 W GARDNER AVE, SPOKANE, WA 99201-2059
(509) 503-6010
(509) 474-9612
Mailing address
PO BOX 10157, SPOKANE, WA 99209-1157
(503) 702-8454
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP61215033
WA
Other
Enumeration date
01/13/2020
Last updated
02/02/2024
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