Healthcare Provider Details

I. General information

NPI: 1043726714
Provider Name (Legal Business Name): GRACE CATHERINE HATCH MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GRACE CATHERINE BIRRENKOTT

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 W BOONE AVE
SPOKANE WA
99201-2309
US

IV. Provider business mailing address

107 S DIVISION ST
SPOKANE WA
99202-1510
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-4651
  • Fax:
Mailing address:
  • Phone: 509-838-4651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSC60832802
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP6047756
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC60832802
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: