Healthcare Provider Details

I. General information

NPI: 1689487340
Provider Name (Legal Business Name): SHAYA SHAVON HOLLAND LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7307 N DIVISION ST STE 311
SPOKANE WA
99208-6554
US

IV. Provider business mailing address

1221 E LIBERTY AVE
SPOKANE WA
99207-2869
US

V. Phone/Fax

Practice location:
  • Phone: 509-557-0070
  • Fax:
Mailing address:
  • Phone: 509-270-6810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG61658615
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTA.MG.70126186
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: