Healthcare Provider Details

I. General information

NPI: 1225946114
Provider Name (Legal Business Name): EMBER NORTH BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 W RIVERSIDE AVE STE 1015
SPOKANE WA
99201-0402
US

IV. Provider business mailing address

421 W RIVERSIDE AVE STE 1015
SPOKANE WA
99201-0402
US

V. Phone/Fax

Practice location:
  • Phone: 509-903-6649
  • Fax: 509-960-5926
Mailing address:
  • Phone: 509-903-6649
  • Fax: 509-960-5926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AUDREY GRIMM
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 208-797-6262