Healthcare Provider Details

I. General information

NPI: 1861990848
Provider Name (Legal Business Name): KOLLEEN J SEWARD CDP, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KOLLEEN J FOORE CDP

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 W BROADWAY
SPOKANE WA
99201
US

IV. Provider business mailing address

106 W MISSION AVE
SPOKANE WA
99201-2337
US

V. Phone/Fax

Practice location:
  • Phone: 509-252-6775
  • Fax: 509-473-4840
Mailing address:
  • Phone: 509-598-7628
  • Fax: 509-473-4840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: