Healthcare Provider Details

I. General information

NPI: 1710453964
Provider Name (Legal Business Name): EMILY PEREZ PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 N WALL ST STE 100
SPOKANE WA
99205-6435
US

IV. Provider business mailing address

1111 S HAZELWOOD RD
SPOKANE WA
99224-9297
US

V. Phone/Fax

Practice location:
  • Phone: 509-415-3507
  • Fax: 857-270-7251
Mailing address:
  • Phone: 615-636-3033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60909603
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: