Healthcare Provider Details

I. General information

NPI: 1780871442
Provider Name (Legal Business Name): MICHELLE M. WHITE, PH.D. AND ASSOCIATES, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 01/27/2010
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: 509-534-9380
  • Fax: 509-534-9385
Mailing address:
  • Phone: 509-534-9380
  • Fax: 509-534-9385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY00001933
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY00001933
License Number StateWA

VIII. Authorized Official

Name: DR. MICHELLE M. WHITE
Title or Position: CLINICAL NEUROPSYCHOLOGIST
Credential: PH.D.
Phone: 509-534-9380