Marketing agencies in Spokane: 69 offices, a small market and Washington's rule on health-related ad targeting

For Inland Northwest businesses hiring an agency, especially clinics, practices and others in health care, and for vendors that sell to small agencies. The metro is Spokane and Stevens counties.

The Spokane market in figures

US Census Bureau, County Business Patterns 2023, Spokane-Spokane Valley, WA Metro Area (CBSA 44060), NAICS 5418 (advertising, public relations and related services):

Spokane County has 68 of the 69 offices and 562 of the employees. Of the offices, 60 have fewer than 20 people.

What the count covers. Establishments with paid employees in March 2023. A freelancer with no payroll isn't counted, and an agency with two offices counts twice. Codes are NAICS 2017.

What kind of agency

Advertising agencies (NAICS 541810: full-service, creative, digital and paid media) are the core, with 35 offices and 367 employees, about $83,200 in average pay. The smaller codes have few offices and high-noise employee figures (the Census Bureau publishes them but flags that confidentiality noise moved them by 5% or more): 13 offices in promotional products, sign lettering and other advertising services (541890), 9 in billboards and display (541850) and 5 PR agencies (541820). Seven more offices sit in codes too small to publish.

Three related industries are as big as the agencies: 77 marketing consultancies (541613) with 182 employees, 22 graphic design studios (541430) and 74 custom programming firms (541511), the code the Census index uses for custom SEO and web page design. In a small market, look across all four codes.

Washington's geofence rule

Washington's My Health My Data Act, passed in 2023, makes it unlawful to implement a geofence around an entity that provides in-person health care services when the geofence is used to identify or track consumers seeking care, to collect their health data, or to send them notifications, messages or ads tied to their health data or to health care services (RCW 19.373.080). A geofence here is a virtual boundary 2,000 feet or less from the perimeter of the location (RCW 19.373.010). The law's "consumer health data" covers personal information that identifies a person's past, present or future physical or mental health status.

What that means when you hire an agency:

• Clinics, dental and therapy practices, pharmacies and hospitals: ask exactly how the agency targets location. Radius targeting around your own or a competitor's site is the obvious risk.
• Any advertiser near a clinic: a tight radius around a shopping center that includes an urgent care can still catch it. Ask for the targeting settings in writing.
• Data: if the agency handles patient or health-related customer lists, the contract should limit what it does with them and require their return or deletion at the end.

The rest of the vetting

1. Look the business up. Use Washington's Department of Revenue business lookup to confirm the business is licensed with the state, and the Secretary of State's Corporations and Charities System shows the entity and its status.
2. Keep your accounts. Google requires agencies to give advertisers their Google Ads customer ID on request, to show any management fee separately in writing and on every invoice, and, when reports are promised, to report the exact amount Google charged excluding fees.
3. Own the work. Ask for a written copyright assignment: the US Copyright Office explains that commissioned work is a work made for hire only in nine narrow categories with a signed agreement.
4. Price it by role and hours. Omnicom's 2025 10-K lists the usual bases for agency fees: agreed or hourly fees, commissions on media, incentives tied to results and pass-through costs. For a benchmark, federal schedule contracts in GSA's CALC+ data put the national median ceiling at about $128 an hour for an SEO specialist (five contractors) and $146 for an analyst (nine), our calculation on 30 October 2026. Spokane's agency pay is well below the national average.
5. Call two references, one of them a client that left.

Selling to Spokane agencies

Every buyer here is an owner or a partner: 60 of 69 offices have fewer than 20 people, and most of the 77 consultancies and 22 design studios have one to four people. A Spokane list on its own is short, so it often makes sense to treat the Inland Northwest as one territory and lead with something local.

Illustrative example. The vendor, price and reply rate are invented.

Palouse Tags (palousetags.example) sells a compliance check for location-targeted campaigns, flagging any radius that touches a health care site, at $150 a month. Washington's geofence rule gives it a reason to write to every agency that runs local paid media: the 35 advertising agencies plus perhaps 40 consultancies that advertise paid search or social, about 75 in all. An illustrative 12% reply rate gives nine conversations. Bebop can find the agencies that run location-based ads and the owner at each.

Subject: Geofences near clinics

Hi [first name],

Quick one for agencies running local campaigns in Washington: the My Health My Data Act bans geofences within 2,000 feet of in-person health care providers when they're used to target health-related ads or track visitors.

[Product] checks every radius in your client accounts against [what you check, e.g. a map of licensed health care sites] and flags the ones that touch a clinic, before a client gets a letter.

Want a free scan of one client account?

[Your name]
[Company, postal address]
Reply "no" and I won't follow up.

Spokane sources

There's no public agency group based here either: no SEC registrant in SIC 7310 to 7319 lists a Spokane-area address.

Next step: for the national picture and how larger agencies are organized, see the largest advertising agencies and how to build a list, or the NAICS codes for marketing businesses.