Healthcare Provider Details

I. General information

NPI: 1083584221
Provider Name (Legal Business Name): LILDRA J FIFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 N DISCOVERY PL
SPOKANE VALLEY WA
99216-1566
US

IV. Provider business mailing address

2412 W GIBBS RD
SPOKANE WA
99224-8567
US

V. Phone/Fax

Practice location:
  • Phone: 509-747-4174
  • Fax:
Mailing address:
  • Phone: 509-844-6855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: