Individual
DR. RUSSELL L KOLTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10103 N DIVISION ST, SUITE 109, SPOKANE, WA 99218-1380
(509) 467-1156
Mailing address
PO BOX 31237, SPOKANE, WA 99223-3020
(509) 998-6265
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60198057
WA
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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