Healthcare Provider Details

I. General information

NPI: 1841684230
Provider Name (Legal Business Name): PATHWAYS OF WASHINGTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 N ARGONNE RD SUITE 102
SPOKANE VALLEY WA
99212-6011
US

IV. Provider business mailing address

1050 N ARGONNE RD STE 100
SPOKANE VALLEY WA
99212-6011
US

V. Phone/Fax

Practice location:
  • Phone: 509-209-8990
  • Fax: 509-919-4877
Mailing address:
  • Phone: 509-209-8990
  • Fax: 509-919-4877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number5299
License Number StateWA

VIII. Authorized Official

Name: MS. AMIKA TANIGUCHI
Title or Position: STATE DIRECTOR
Credential:
Phone: 509-209-8993