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General NPI Number Information
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NPI Number | 1992191563
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Entity Type | Individual
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Provider Name | MICHELE KORINNE RIORDAN MSW
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Gender | Female
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 2118 E SPRAGUE AVE
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City | SPOKANE
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State | WA
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Zip | 99202-3125
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Country | US
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Telephone | 509-838-4651
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Fax |
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Provider Business Mailing Address
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Address Line | 2804 W LONGFELLOW AVE
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City | SPOKANE
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State | WA
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Zip | 99205-1513
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Country | US
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Telephone | 509-710-3274
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH61123241
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MC60538327
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License Number State | WA
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