SearchWashington101YM0800X

Jeffrey Wallace, LICSW, MSW, CDP, MHP

NPI 1538557012 · on the registry since 2015 · sole proprietor

Practice

Address
400 S Jefferson St Ste 200
Spokane, WA 99204
Phone
(509) 822-8662
Organisation at this address
Mikolasy, Llc
Indigo Gardens Llc
Charmed Counseling
Massage For Life Llc
River City Tms, Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
60

Additional practice sites

  • 22 S. Thor St., Spokane, WA

Registry record

Primary taxonomy
101YM0800X
101YM0800X
Also registered as
1041C0700X
101YA0400X
Licence states on file
WA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-01-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington