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NPI Code Detail

MEDICARE: JESSICA RICHTER CP60234158

MEDICARE: JESSICA RICHTER CP60234158
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCP60234158WA

General Provider Information

NPI Number : 1770024382
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA RICHTER CP60234158
Provider Business Mailing Address
First Line : 812 S WALNUT ST
Second Line :
City : SPOKANE
State : WA
Zip : 99204-3326
Country : US
Telephone Number : 509-624-5228
Fax Number : 509-624-7620
Provider Business Practice Location Address
First Line : 812 S WALNUT ST
Second Line :
City : SPOKANE
State : WA
Zip : 99204-3326
Country : US
Telephone Number : 509-624-5228
Fax Number : 509-624-7620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2017
Last Update Date : 03/15/2017

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Directions to “ JESSICA RICHTER CP60234158” Practice Location

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