Healthcare Provider Details

I. General information

NPI: 1487126348
Provider Name (Legal Business Name): KIMBERLY LYNN HARPER LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLY LYNN CLARK LMFTA, RN

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S FREYA ST
SPOKANE WA
99202-4862
US

IV. Provider business mailing address

522 W RIVERSIDE AVE STE N
SPOKANE WA
99201-0581
US

V. Phone/Fax

Practice location:
  • Phone: 509-389-7576
  • Fax:
Mailing address:
  • Phone: 509-768-2249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number70122509
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: