Healthcare Provider Details

I. General information

NPI: 1346574258
Provider Name (Legal Business Name): JEPHLINE OKOTH PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 N SULLIVAN RD STE 100-1040
SPOKANE VALLEY WA
99216-5198
US

IV. Provider business mailing address

20318 TARPON BAY LN
CYPRESS TX
77433-5184
US

V. Phone/Fax

Practice location:
  • Phone: 832-887-4600
  • Fax:
Mailing address:
  • Phone: 832-887-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1036298
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: