Healthcare Provider Details

I. General information

NPI: 1184866188
Provider Name (Legal Business Name): MARVIN GEORGE DEUBEL JR. B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 04/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 N DISCOVERY PL
SPOKANE VALLEY WA
99216-1566
US

IV. Provider business mailing address

407 E ELM RD
SPOKANE WA
99218-1409
US

V. Phone/Fax

Practice location:
  • Phone: 509-747-4174
  • Fax: 509-838-3874
Mailing address:
  • Phone: 509-768-0935
  • 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: