Healthcare Provider Details

I. General information

NPI: 1588571244
Provider Name (Legal Business Name): JENNY ANNE MANNAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8303 N DIVISION ST
SPOKANE WA
99208-5715
US

IV. Provider business mailing address

35 W 14TH AVE
SPOKANE WA
99204-3611
US

V. Phone/Fax

Practice location:
  • Phone: 509-816-6662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: