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General NPI Number Information
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NPI Number | 1336932508
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Entity Type | Individual
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Provider Name | MARISA KOLE
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Gender | Female
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 3527 E SPRAGUE AVE STE H
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City | SPOKANE
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State | WA
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Zip | 99202-4894
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Country | US
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Telephone | 509-368-7556
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Fax | 509-808-2267
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Provider Business Mailing Address
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Address Line | 3608 E 20TH AVE
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City | SPOKANE
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State | WA
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Zip | 99223-5409
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Country | US
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Telephone | 509-368-7556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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