Individual
TRISTA WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
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
AP61134921
WA
363L00000X
Nurse Practitioner
AP61134921
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP61134921
STATE LICENSE
WA
Enumeration date
01/25/2021
Last updated
03/04/2021
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