Healthcare Provider Details

I. General information

NPI: 1992622401
Provider Name (Legal Business Name): HEALTHY WITH HADER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 W SANSON AVE
SPOKANE WA
99205-5745
US

IV. Provider business mailing address

2610 W SANSON AVE
SPOKANE WA
99205-5745
US

V. Phone/Fax

Practice location:
  • Phone: 509-499-4881
  • Fax:
Mailing address:
  • Phone: 509-499-4881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH M HADER
Title or Position: REGISTERED DIETITIAN
Credential: RD
Phone: 509-499-4881