Healthcare Provider Details

I. General information

NPI: 1588598932
Provider Name (Legal Business Name): MEKDES GEBISSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 E 22ND AVE
SPOKANE WA
99223-3910
US

IV. Provider business mailing address

3609 E 22ND AVE
SPOKANE WA
99223-3910
US

V. Phone/Fax

Practice location:
  • Phone: 206-356-7493
  • Fax: 509-443-4683
Mailing address:
  • Phone: 206-356-7493
  • Fax: 509-443-4683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: