Healthcare Provider Details

I. General information

NPI: 1063933406
Provider Name (Legal Business Name): JULIA A SPALDING MSW, LICSWA, SUDP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 BROADWAY ST
LONGVIEW WA
98632-3830
US

IV. Provider business mailing address

PO BOX 2394
LONGVIEW WA
98632-8455
US

V. Phone/Fax

Practice location:
  • Phone: 360-998-3050
  • Fax: 844-612-6673
Mailing address:
  • Phone: 360-998-3050
  • Fax: 844-612-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG60781199
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP60927264
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC70082088
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: