Healthcare Provider Details

I. General information

NPI: 1881858330
Provider Name (Legal Business Name): JULIANN KAYLENE HAFFEY MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 S UNIVERSITY RD STE 202
SPOKANE VALLEY WA
99206-6164
US

IV. Provider business mailing address

325 S UNIVERSITY RD STE 202
SPOKANE VALLEY WA
99206-6164
US

V. Phone/Fax

Practice location:
  • Phone: 509-385-0292
  • Fax: 509-534-9385
Mailing address:
  • Phone: 509-385-0292
  • Fax: 509-534-9385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60116244
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: