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Individual

LONI MARIE SPRAGUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
320 N CHELAN AVE, WENATCHEE, WA 98801-2107
(509) 663-5244
(509) 664-6508
Mailing address
1005 DOWNS RD, WENATCHEE, WA 98801-9630
(253) 222-0392

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00016366
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0213594
L&I
WA
01
7935473
AETNA
WA
Enumeration date
06/11/2007
Last updated
07/08/2007
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