Healthcare Provider Details

I. General information

NPI: 1013830934
Provider Name (Legal Business Name): MARISITY ARRIN JAGIM-KERN LICSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 E FRONT AVE
SPOKANE WA
99202-2139
US

IV. Provider business mailing address

1311 E KIERNAN AVE
SPOKANE WA
99207-2965
US

V. Phone/Fax

Practice location:
  • Phone: 509-626-9900
  • Fax:
Mailing address:
  • Phone: 509-960-0872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWIA.SC.70134274
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: