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General NPI Number Information
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NPI Number | 1730034141
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Entity Type | Individual
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Provider Name | ERIN MCGILLICUDDY
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Gender | Female
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 3400 W GARLAND AVE
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City | SPOKANE
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State | WA
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Zip | 99205-2119
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Country | US
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Telephone | 509-325-2355
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Fax | 509-326-3370
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Provider Business Mailing Address
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Address Line | 3400 W GARLAND AVE APT 9
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City | SPOKANE
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State | WA
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Zip | 99205-2119
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Country | US
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Telephone | 509-325-2355
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Fax | 509-326-3370
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | CPST.PE.70105201
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License Number State | WA
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