Healthcare Provider Details

I. General information

NPI: 1902086697
Provider Name (Legal Business Name): LEANN MARIE DEERING-SOTH MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10814 E BROADWAY AVE SUITE 001
SPOKANE VALLEY WA
99206-5003
US

IV. Provider business mailing address

18808 E. MARLIN DR.
SPOKANE VALLEY WA
99027
US

V. Phone/Fax

Practice location:
  • Phone: 509-325-0744
  • Fax:
Mailing address:
  • Phone: 509-325-0744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberRC00056490
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number419417A
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: