Healthcare Provider Details

I. General information

NPI: 1669391199
Provider Name (Legal Business Name): MR. STEPHEN PHILLIP LEWIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S FREYA ST BLUE FLAG BLDG., SUITE 206
SPOKANE WA
99202-4862
US

IV. Provider business mailing address

104 S FREYA ST BLUE FLAG BLDG., SUITE 206
SPOKANE WA
99202-4862
US

V. Phone/Fax

Practice location:
  • Phone: 509-903-5818
  • Fax:
Mailing address:
  • Phone: 509-903-5818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMG.61548592
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: