Russell Mikami
May also be knows as Lighthouse Physical Therapy
Specialist in Spokane Valley, WA(View on Map)
Legal Business Name
Russell Mikami
Also Known As
Lighthouse Physical Therapy
NPI Number
1851606586
NPI Type
Organization
Enumeration Date
08/18/2010
Specialties
(Taxonomies)Licenses
State
Washington
License Number
PT 00003614
Contact
Information
Purpose
Mailing
Location
Address
15413 E VALLEYWAY AVE BLDG B-200
15413 E VALLEYWAY AVE BLDG B-200
City
Spokane Valley
Spokane Valley
State
WA
WA
Postal Code
99037-8554
99037-8554
Country
US
US
Telephone Number
(509) 928-3443
(509) 928-3443
Authorized Official
Name
Mrs. Gloria Mikami
Title or Position
BUSINESS MANAGER
Telephone Number
(509) 928-3443
Identifiers
Identifier
7107527
Identifier State
WA
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/18/2010
Provider Address
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