Healthcare Provider Details

I. General information

NPI: 1588578686
Provider Name (Legal Business Name): TERESA ASBURY MSW
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: TERESA DIXON MSW

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W SPRAGUE AVE
SPOKANE WA
99201-3627
US

IV. Provider business mailing address

210 W SPRAGUE AVE
SPOKANE WA
99201-3627
US

V. Phone/Fax

Practice location:
  • Phone: 509-747-8224
  • Fax:
Mailing address:
  • Phone: 509-747-8224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: