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General NPI Number Information
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NPI Number | 1013727734
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Entity Type | Organization
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Legal Business Name | FLOURISH: DISEASE PREVENTION AND MANAGEMENT LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 612 E 23RD AVE
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City | SPOKANE
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State | WA
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Zip | 99203-2346
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Country | US
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Telephone | 425-223-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 612 E 23RD AVE
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City | SPOKANE
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State | WA
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Zip | 99203-2346
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GOVERNOR
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Name | RILEY MCCORKLE
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Credential | RDN CDCES
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Telephone | 425-223-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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