Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | OOO17310WA | WA |
NPI | 1093747719 |
---|---|
Provider Name | Dr. Gary Lester Noland |
First Address | Spokane, WA 99202-4932 |
Second Address | Spokane Valley, WA 99216-1875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 29/11/2021 |