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General NPI Number Information
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NPI Number | 1720133952
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Entity Type | Individual
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Provider Name | MICHAEL R. HATHAWAY M.F.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 322 W NORTH RIVER DR
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City | SPOKANE
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State | WA
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Zip | 99201-3208
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Country | US
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Telephone | 509-324-6464
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34581
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City | SEATTLE
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State | WA
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Zip | 98124-1581
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Country | US
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Telephone | 509-241-7349
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Fax | 509-241-7628
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF20000864
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License Number State | WA
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