Healthcare Provider Details

I. General information

NPI: 1174802524
Provider Name (Legal Business Name): MELISA MAJNARICH LICSW LW 60185668
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 N MONROE ST
SPOKANE WA
99201
US

IV. Provider business mailing address

930 N MONROE ST
SPOKANE WA
99201
US

V. Phone/Fax

Practice location:
  • Phone: 509-789-9297
  • Fax: 509-444-0488
Mailing address:
  • Phone: 509-789-9297
  • Fax: 509-444-0488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW 60185668
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLW 60185668
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: