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1790835932
STACEY NOEL BOOMER
SPOKANE, WA
NPI
1790835932
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Former Name
STACEY NOEL ROBERTS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA PA10005143)
Enumeration Date
2007-01-11
Last Update Date
2022-01-27
Business Address
STACEY NOEL BOOMER PA-C
322 W NORTH RIVER DR
SPOKANE, WA 99201-3208
Phone number: 509-324-6464
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Mailing Address
STACEY NOEL BOOMER PA-C
322 W NORTH RIVER DR
SPOKANE, WA 99201-3208
Phone number: 509-324-6464
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