Healthcare Provider Details

I. General information

NPI: 1013727734
Provider Name (Legal Business Name): FLOURISH: DISEASE PREVENTION AND MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 E 23RD AVE
SPOKANE WA
99203-2346
US

IV. Provider business mailing address

612 E 23RD AVE
SPOKANE WA
99203-2346
US

V. Phone/Fax

Practice location:
  • Phone: 425-223-7111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RILEY MCCORKLE
Title or Position: GOVERNOR
Credential: RDN CDCES
Phone: 425-223-7111