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1124 W Riverside Ave # Ll2 Spokane WA 99201-1132 | |
| (509) 994-6232 | |
| (509) 323-1607 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 1124 W Riverside Ave # Ll2, Spokane, Washington |
| Authorized Official Name and Position | Teddi Lou Greene (OWNER/PROVIDER) |
| Authorized Official Contact | 5099946232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1124 W Riverside Ave # Ll2 Spokane WA 99201-1132 Ph: (509) 994-6232 | 1124 W Riverside Ave # Ll2 Spokane WA 99201-1132 Ph: (509) 994-6232 |
| NPI Number | 1942776018 |
|---|---|
| Provider Enumeration Date | 10/16/2018 |
| Last Update Date | 12/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942776018 | NPI | - | NPPES |
| 2103521 | Medicaid | WA | |
| LW60291569 | Other | WA | STATE DEPARTMENT OF HEALTH LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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