Healthcare Provider Details

I. General information

NPI: 1982136974
Provider Name (Legal Business Name): CARA ZOA STRANGE CDP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W COLLEGE AVE
SPOKANE WA
99201-2010
US

IV. Provider business mailing address

1101 W COLLEGE AVE
SPOKANE WA
99201-2010
US

V. Phone/Fax

Practice location:
  • Phone: 509-324-1425
  • Fax: 509-327-0163
Mailing address:
  • Phone: 509-324-1425
  • Fax: 509-327-0163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number60492744
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: