Individual
CARRIE PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
820 S MCCLELLAN ST STE 300, SPOKANE, WA 99204-2450
(509) 838-7100
(509) 227-7070
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60604817
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/18/2014
Last updated
07/13/2019
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