Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT00006155 | WA |
NPI | 1295999621 |
---|---|
Provider Name | Renee Lach |
First Address | Spokane, WA 99203-2334 |
Second Address | Spokane, WA 99204-2901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 15/07/2008 |