Healthcare Provider Details

I. General information

NPI: 1205752359
Provider Name (Legal Business Name): KARINA BAVERY LMFT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11409 N GUINEVERE DR
SPOKANE WA
99218-1825
US

IV. Provider business mailing address

19 S VERNON AVE UNIT 506
DEER PARK WA
99006-1159
US

V. Phone/Fax

Practice location:
  • Phone: 209-624-9786
  • Fax:
Mailing address:
  • Phone: 209-624-9786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KARINA ELENA BAVERY
Title or Position: MH CLINICIAN
Credential: LMFT
Phone: 209-624-9786