Provider Demographics
NPI:1598949901
Name:GRAVES, DAVID LYLE (ND)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LYLE
Last Name:GRAVES
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3137 E 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4706
Mailing Address - Country:US
Mailing Address - Phone:503-819-5348
Mailing Address - Fax:
Practice Address - Street 1:1801 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1819
Practice Address - Country:US
Practice Address - Phone:509-755-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60161938175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath