Provider Information for 1164548707
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DAVID WAYNE SUTTON LPC
Sex: Male
NPI: 1164548707
Last Updated: 2024-08-28
Certification Date: 2024-08-28
Certification Date: 2024-08-28
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1164548707 | ||||||||||||
| Enumeration Date | 2007-03-22 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 100 N HOWARD ST STE W SPOKANE, WA 99201-0508 United States Phone: 214-228-4261 | Fax:972-228-4849 | ||||||||||||
| Primary Practice Address | 100 N HOWARD ST STE W SPOKANE, WA 99201-0508 United States Phone: 817-657-2710 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 1229 E PLEASANT RUN RD | ||||||||||||
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