Individual
DR. ALLISON TILLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
801 S STEVENS ST, SPOKANE, WA 99204-2654
(509) 363-7788
Mailing address
801 S STEVENS ST, SPOKANE, WA 99204-2654
(509) 363-7788
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD60940915
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821417544
NPI
WA
Enumeration date
04/09/2014
Last updated
07/16/2020
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