Healthcare Provider Details

I. General information

NPI: 1780520023
Provider Name (Legal Business Name): STEPHANIE ROXANNE MANNING LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 E HOLLAND AVE STE 101
SPOKANE WA
99218-1257
US

IV. Provider business mailing address

759 E HOLLAND AVE STE 101
SPOKANE WA
99218-1257
US

V. Phone/Fax

Practice location:
  • Phone: 509-270-0065
  • Fax: 509-319-2520
Mailing address:
  • Phone: 509-270-0065
  • Fax: 509-319-2520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.70074849
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: