MEDICARE: MRS. DAWN-ASHLEY DIPO LMHCA, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MC60311791	WA

General Provider Information

NPI Number	:	1104162213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAWN-ASHLEY DIPO LMHCA, NCC

Provider Business Mailing Address
First Line	:	6013 E 6TH AVE
Second Line	:	UNIT O-1
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99212-0454
Country	:	US
Telephone Number	:	509-237-2191
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 N PINES RD
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-5225
Country	:	US
Telephone Number	:	509-237-2191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2012
Last Update Date	:	12/17/2012

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