Healthcare Provider Details

I. General information

NPI: 1184230658
Provider Name (Legal Business Name): ANGELA SMITH MSW, LICSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA BOWLING

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 W 7TH AVE STE 170B
SPOKANE WA
99204-2832
US

IV. Provider business mailing address

707 W 7TH AVE STE 170B
SPOKANE WA
99204-2832
US

V. Phone/Fax

Practice location:
  • Phone: 509-818-0340
  • Fax:
Mailing address:
  • Phone: 509-818-0340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG60723207
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC61325590
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: