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1-----.. ·· -"-'--"-' ....... .. ; , ~ " " . '- Fax - I ; 3115 E. Mission Ave Spokane, WA 99202 From: ruel \:")w @ (i 1::£ Pages: eel I:l Urgamt 0 for Review D Please Comment 0 prease Reply 0 Please Recycle i I . i .. J)OC-=#. tJv-/l . ~ ~ - ----wr;~c*------JF-I!f-------+-· ---.------.--.- ---.---- . {f (JJr.) f ... Jl-..':, () J .. -j;; - fttJ- . . r, vJ- f ~r~r . . J U .~). 16 . ~. (J.;J~ #&f~~ CBR Medical, Inc. - .3115 E. Mission Ave, Spokane, Wa 99202 Seattle Phone 206-774·6493 Fax 206·41 6-6699. Spokane Phone 509-242·8624 Fax 509-340-2710 Tri-Clties Phone 509-416·22.67 Fax 509·340-2.710 V:;;ncouver Phone 360-635-6464 Fax 206-418.6659 CONFIDENTIALITY NOT1C~: This communication is intended for the sale use of the' individual and entfty to whom it is. addressed, and may contain' information that is' pliViIeged, or confidential and exempt from disclosure under applicable law. You are hereby notified that any dissemination, distribution, Dr duplication of this communication by someone other I.han the intended addressee. or its designated agent is strictly prohibited..' . . AlIlnformatiol1 i$ Protected Under u.s. Federal Law PDU-6655-3 000293
STATE O~ WASHItIIGTON DEPARTMENT OF CORRECTIONS AUTHORIZATION FOR DJSCLOSURE OF OI'l'EN= 1,0, OATA; I, hereby authome the use or disclosure of my health information or organization is'authorized to make the disClosure: = ,'D' 1//~ I. . I ~ - =3:/:S= if :~. a hi' SpD ton t1 I l
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STATE OF WASHINGTON DEPARTMENT OF C
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i ( Documentation of Physician Auth
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eRR Medical, Il1c 3115 E. Mission A
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Or-FENDER 1.0. DATA, j' STATE OF WA
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DoCumentation of Medical AuthoriZat
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Chapter 69.51 A RCW: Medical marij1
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Chapter 69.S1A RCW: Medical marijua
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. ! STATE OF WASHINGTON DEPARTMENT
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STATE OF WASHINGTON .DEPARTMENT OF
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Wheeler, Judine L. (DOC) From: Sent
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Prescdbar's Name (pnnt) . Prasc~jje
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I I do ncit want to ruffle feathers
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Interpretation of Medical Marijuana
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From: Sent: To: Duggan, Brenda J. (
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NIELSEN TO COME UPSTAIRS. CCO NIELS
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Date & Tirpe Created: 12/16/2008 11
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PRIMARY CARE PHYSICIAN AND LOOKED O
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Documentation of Medical Authorizat
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