Healthcare Provider Details

I. General information

NPI: 1538007794
Provider Name (Legal Business Name): COMMUNITY PATHWAYS WA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12717 E 4TH AVE APT B201
SPOKANE VALLEY WA
99216-0800
US

IV. Provider business mailing address

12717 E 4TH AVE APT B201
SPOKANE VALLEY WA
99216-0800
US

V. Phone/Fax

Practice location:
  • Phone: 509-970-8537
  • Fax:
Mailing address:
  • Phone: 509-316-5912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KALI JEAN POWELL
Title or Position: MANAGING MEMBER
Credential:
Phone: 208-215-1405