Healthcare Provider Details

I. General information

NPI: 1609107416
Provider Name (Legal Business Name): KEVIN PHILLIP BARKER M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2010
Last Update Date: 01/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 S UNIVERSITY RD SUITE 202
SPOKANE VALLEY WA
99206-5227
US

IV. Provider business mailing address

325 S UNIVERSITY RD SUITE 202
SPOKANE VALLEY WA
99206-5227
US

V. Phone/Fax

Practice location:
  • Phone: 509-385-0290
  • Fax: 509-534-9385
Mailing address:
  • Phone: 509-385-0290
  • Fax: 509-534-9385

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: