Healthcare Provider Details

I. General information

NPI: 1144184169
Provider Name (Legal Business Name): WILLIAM DREW TARVER LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W MAIN AVE STE 200
SPOKANE WA
99201-0172
US

IV. Provider business mailing address

20 W MAIN AVE STE 200
SPOKANE WA
99201-0172
US

V. Phone/Fax

Practice location:
  • Phone: 509-294-3784
  • Fax:
Mailing address:
  • Phone: 509-294-3784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA61681646
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: