Healthcare Provider Details

I. General information

NPI: 1740127158
Provider Name (Legal Business Name): HANNAH MARIE GRAHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE
SPOKANE WA
99201-0580
US

IV. Provider business mailing address

PSC 473 BOX 3817
FPO AP
96349-0039
US

V. Phone/Fax

Practice location:
  • Phone: 919-330-0922
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023560
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: