Healthcare Provider Details

I. General information

NPI: 1790177186
Provider Name (Legal Business Name): HEATHER DI BIASE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2015
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12104 E SKYVIEW AVE
SPOKANE VALLEY WA
99206-7014
US

IV. Provider business mailing address

GENERAL DELIVERY
VERADALE WA
99037-9999
US

V. Phone/Fax

Practice location:
  • Phone: 509-601-3329
  • Fax:
Mailing address:
  • Phone: 509-601-3329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLW60844295
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60844295
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: