Healthcare Provider Details

I. General information

NPI: 1811954373
Provider Name (Legal Business Name): SPOKANE REGIONAL HEALTH DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W COLLEGE AVE
SPOKANE WA
99201-2029
US

IV. Provider business mailing address

1101 W COLLEGE AVE
SPOKANE WA
99201-2029
US

V. Phone/Fax

Practice location:
  • Phone: 509-324-1660
  • Fax: 509-324-3609
Mailing address:
  • Phone: 509-324-1660
  • Fax: 509-324-3609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number50D0672084
License Number StateWA

VIII. Authorized Official

Name: PAULA MAXWELL
Title or Position: PROGRAM MANAGER
Credential:
Phone: 509-324-1660