Provider Demographics
NPI:1235581612
Name:COURTNEY, CANDACE (LMT)
Entity Type:Individual
Prefix:MISS
First Name:CANDACE
Middle Name:
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 E ERMINA AVE
Mailing Address - Street 2:APT #4
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2215
Mailing Address - Country:US
Mailing Address - Phone:509-769-8890
Mailing Address - Fax:
Practice Address - Street 1:2207 N MOLTER RD
Practice Address - Street 2:STE #250
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7570
Practice Address - Country:US
Practice Address - Phone:509-893-9939
Practice Address - Fax:509-893-9107
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60437417225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist