MEDICARE: MALEIA MICHELLE MATT LICSW

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	1041C0700X	Clinical Social Worker	LW61017214	WA

General Provider Information

NPI Number	:	1033786934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALEIA MICHELLE MATT LICSW

Provider Business Mailing Address
First Line	:	12806 E 34TH CT
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-8367
Country	:	US
Telephone Number	:	253-732-1085
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 W RIVERSIDE AVE STE 972
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-0402
Country	:	US
Telephone Number	:	509-822-3992
Fax Number	:	866-582-2928

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	10/08/2025

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