Healthcare Provider Details

I. General information

NPI: 1063683639
Provider Name (Legal Business Name): DEANETTE LYNNE PALMER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2008
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 W 7TH AVENUE SUITE 230
SPOKANE WA
99204
US

IV. Provider business mailing address

703 W 7TH AVENUE SUITE 230
SPOKANE WA
99204
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-8022
  • Fax: 509-744-0912
Mailing address:
  • Phone: 509-838-8022
  • Fax: 509-744-0912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberWA1302
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: