Healthcare Provider Details

I. General information

NPI: 1053965368
Provider Name (Legal Business Name): PACIFIC NORTHWEST COUNSELING AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 07/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 W BOONE AVE STE 656
SPOKANE WA
99201-2346
US

IV. Provider business mailing address

316 W BOONE AVE STE 656
SPOKANE WA
99201-2346
US

V. Phone/Fax

Practice location:
  • Phone: 509-242-7200
  • Fax:
Mailing address:
  • Phone: 509-242-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KANDI ARNHOLD
Title or Position: ADMINISTRATION
Credential:
Phone: 360-770-2955