Healthcare Provider Details

I. General information

NPI: 1215849708
Provider Name (Legal Business Name): KRYSTAL ANN ATWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3928 N POST ST
SPOKANE WA
99205-1148
US

IV. Provider business mailing address

3928 N POST ST
SPOKANE WA
99205-1148
US

V. Phone/Fax

Practice location:
  • Phone: 763-291-3060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0002455
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC.LH.70109866
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberATRBC18488
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0016462
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: