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1861055006
SHAD FLY
SPOKANE, WA
NPI
1861055006
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: WA AP61299457)
Enumeration Date
2019-04-15
Last Update Date
2022-06-22
Business Address
SHAD FLY
800 W 5TH AVE
SPOKANE, WA 99204-2803
Phone number: 509-458-5800
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Mailing Address
SHAD FLY
23225 E MAXWELL AVE
LIBERTY LAKE, WA 99019-8559
Phone number: 661-231-5443
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