Healthcare Provider Details

I. General information

NPI: 1972292308
Provider Name (Legal Business Name): MARY JOAN WARD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N ARGONNE RD
SPOKANE VALLEY WA
99212-2699
US

IV. Provider business mailing address

23004 E VALLEYWAY AVE
LIBERTY LAKE WA
99019-9416
US

V. Phone/Fax

Practice location:
  • Phone: 509-701-8515
  • Fax:
Mailing address:
  • Phone: 509-701-8515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCAAR.CG.70162165
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: