Healthcare Provider Details

I. General information

NPI: 1033855697
Provider Name (Legal Business Name): JAY VALENTINE SEMMONS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2022
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 N WALL ST STE 202
SPOKANE WA
99201-0822
US

IV. Provider business mailing address

221 N WALL ST STE 202
SPOKANE WA
99201-0822
US

V. Phone/Fax

Practice location:
  • Phone: 509-436-9659
  • Fax:
Mailing address:
  • Phone: 509-436-9659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWIA.SC.61648255
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: