Most Relevant Information
Provider Data
| NPI Number: | 1003480021 |
| Provider Name: | JUSTIN A MASHTARE |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | CG61180704 |
Most Important Dates
| Enumeration Date: | 05/14/2021 |
| Last Updated: | 05/14/2021 |
Provider Practice Location
3910 W INDIAN TRAIL RD
SPOKANE
WA
992084739
Practice Location Phone/Fax
| Phone: | 5095593100 |
| Fax: |
Provider Mailing Location
3754 W INDIAN TRAIL RD
SPOKANE
WA
992084736
Provider Mailing Phone/Fax
| Phone: | 5095593100 |
| Fax: |