Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD00037992 | WA |
NPI | 1063523546 |
---|---|
Provider Name | Dr. Ronda Jean Gretebeck |
First Address | Spokane, WA 99224-8256 |
Second Address | Spokane, WA 99204-2361 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |