Healthcare Provider Details

I. General information

NPI: 1588808224
Provider Name (Legal Business Name): KEVIN DAYTON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12810 E NORA AVE STE F
SPOKANE VALLEY WA
99216-1055
US

IV. Provider business mailing address

2514 S SONORA DR
SPOKANE VALLEY WA
99037-9011
US

V. Phone/Fax

Practice location:
  • Phone: 208-929-5204
  • Fax:
Mailing address:
  • Phone: 208-929-5204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number350477-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: