Healthcare Provider Details
I. General information
NPI: 1083509277
Provider Name (Legal Business Name): RESOLUTION COUNSELING SPOKANE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
705 W 7TH AVE STE A-2
SPOKANE WA
99204-2836
US
IV. Provider business mailing address
2715 E 36TH AVE APT 5204
SPOKANE WA
99223-4577
US
V. Phone/Fax
- Phone: 509-822-8662
- Fax:
- Phone: 509-822-8662
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JEFFREY
EUGENE
WALLACE
Title or Position: OWNER
Credential: LICSW
Phone: 509-822-8662