MEDICARE: SPOKANE CONSULTANTS IN FAMILY LIVING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	020701RC00001355	WA

General Provider Information

NPI Number	:	1023568896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPOKANE CONSULTANTS IN FAMILY LIVING

Provider Business Mailing Address
First Line	:	1623 W GARDNER AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-1830
Country	:	US
Telephone Number	:	509-328-6274
Fax Number	:	509-326-2341

Provider Business Practice Location Address
First Line	:	1623 W GARDNER AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-1830
Country	:	US
Telephone Number	:	509-328-6274
Fax Number	:	509-326-2341

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NANCY JOHNSON
Credential	:	MSW
Telephone Number	:	509-328-6274

Provider Enumeration Date	:	10/05/2016
Last Update Date	:	10/05/2016

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