Healthcare Provider Details

I. General information

NPI: 1396698056
Provider Name (Legal Business Name): GOODWILL INDUSTRIES OF THE INLAND NORTHWEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E 3RD AVE
SPOKANE WA
99202-1491
US

IV. Provider business mailing address

130 E 3RD AVE
SPOKANE WA
99202-1491
US

V. Phone/Fax

Practice location:
  • Phone: 509-444-4305
  • Fax: 509-444-4305
Mailing address:
  • Phone: 509-444-4305
  • Fax: 509-444-4305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. TAMBERLY LYNN DAVIS
Title or Position: ADMINISTRATIVE SERVICES DIRECTOR
Credential:
Phone: 509-444-4305