Healthcare Provider Details

I. General information

NPI: 1528399672
Provider Name (Legal Business Name): PALOUSE PSYCHIATRY AND BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 SE BISHOP BLVD SUITE 203
PULLMAN WA
99163-5502
US

IV. Provider business mailing address

840 SE BISHOP BLVD SUITE 101
PULLMAN WA
99163-5502
US

V. Phone/Fax

Practice location:
  • Phone: 509-339-2394
  • Fax: 509-336-7484
Mailing address:
  • Phone: 509-332-6139
  • Fax: 509-332-6579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEVEN FEBUS
Title or Position: CFO
Credential:
Phone: 509-332-6139