IVAN J REVERON

SPOKANE, WA
NPI1750393781
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: WA  MD60063800)
Enumeration Date2006-08-11
Last Update Date2012-07-26
Business Address
-- IVAN J REVERON M.D.
5901 N LIDGERWOOD ST STE 126
SPOKANE, WA 99208-1122
Phone number: 509-434-1990
Mailing Address
-- IVAN J REVERON M.D.
203 N WASHINGTON ST STE 300
SPOKANE, WA 99201-0233
Phone number: 509-444-8888
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