MEDICARE: HEATHER STILES

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	101YM0800X	Mental Health Counselor	LH60126454	WA

General Provider Information

NPI Number	:	1306190798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER STILES

Provider Business Mailing Address
First Line	:	4202 SOUTH REGAL STREET
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-7738
Country	:	US
Telephone Number	:	509-340-7183
Fax Number	:	509-789-3780

Provider Business Practice Location Address
First Line	:	1208 W MALLON AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2041
Country	:	US
Telephone Number	:	509-477-2427
Fax Number	:	509-477-6460

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

Provider Enumeration Date	:	11/06/2012
Last Update Date	:	04/22/2019

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Directions to “ HEATHER STILES ” Practice Location

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