Individual
DACOTAH J SPURGEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PT, PA-C
Contact information
Practice address
1114 W 20TH AVE, SPOKANE, WA 99203-1147
(509) 230-3745
Mailing address
1114 W 20TH AVE, SPOKANE, WA 99203-1147
(509) 230-3745
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT00009166
WA
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172561
LABOR AND INDUSTRY /L&I/ WASHINGTON STATE
WA
05
—
8362733
—
WA
Enumeration date
11/06/2006
Last updated
09/13/2019
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