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827 W 1st Ave Ste 415 Spokane WA 99201-3904 | |
| (509) 612-3365 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 827 W 1st Ave Ste 415, Spokane, Washington |
| Authorized Official Name and Position | Kelsey Martell (PHYSICIAN/OWNER) |
| Authorized Official Contact | 5096123365 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
827 W 1st Ave Ste 415 Spokane WA 99201-3904 Ph: (509) 612-3365 | 827 W 1st Ave Ste 415 Spokane WA 99201-3904 Ph: (509) 612-3365 |
| NPI Number | 1700655594 |
|---|---|
| Provider Enumeration Date | 12/21/2023 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700655594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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