Provider Demographics
NPI:1578960415
Name:SUTHERLAND, WILLIAM A JR (HIS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:SUTHERLAND
Suffix:JR
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15701 E SPRAGUE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-5019
Mailing Address - Country:US
Mailing Address - Phone:509-323-9229
Mailing Address - Fax:509-323-9255
Practice Address - Street 1:15701 E SPRAGUE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-5019
Practice Address - Country:US
Practice Address - Phone:509-323-9229
Practice Address - Fax:509-323-9255
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA60471670237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist