MR. JEFFREY EUGENE WALLACE (NPI# 1538557012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1538557012 |
Entity Type | Individual |
Full Name | MR. JEFFREY EUGENE WALLACE |
Other Name | JEFF WALLACE |
Credential | LICSW, MSW, CDP, MHP |
Practice Address |
400 S Jefferson St Ste 200 Spokane WA 99204-3143 |
Practice Telephone | 5098228662 |
Mailing Telephone | 5098228662 |
Enumeration Date | 2015-01-06 |
Last Update Date | 2019-01-28 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CO60490069 | WA | Behavioral Health & Social Service Providers |
Y | 101YM0800X |
Counselor Specialization: Mental Health |
SC60493319 | WA | Behavioral Health & Social Service Providers |
N | 1041C0700X |
Social Worker Specialization: Clinical |
SC60493319 | WA | Behavioral Health & Social Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
22 S. Thor St., Spokane, WA 99202 | 5095322000 | 5095322005 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629089156 | Jeffrey S Wallace | Orthopaedic Surgery | 6800 Heritage Pkwy Ste 102, Rockwall, TX 75087-8746 | 2006-08-10 |
1821014838 | Jeffrey W Wallace | Dentist | 74 Grafton Rd, Townshend, VT 05353-0262 | 2006-07-14 |
1568499234 | Jeffrey A. Wallace I | Pharmacist | 5420 Lancaster Dr, Kaiser Permanente Pharmacy Administration, Brooklyn Heights, OH 44131-1832 | 2006-06-27 |
1679563928 | Jeffrey David Wallace | Chiropractor | 820 Charlevoix Dr, Suite 210, Grand Ledge, MI 48837-8188 | 2005-10-27 |
1548262108 | Jeffrey Leigh Wallace | Preventive Medicine | 411 N Section St, Fairhope, AL 36532-2649 | 2005-08-12 |
1619392974 | Jeffrey Michael Wallace | Physician Assistant | 600 Caisson Hill Rd, Fort Riley, KS 66442-7037 | 2014-02-24 |
1306006796 | Jeffrey Robert Wallace | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Building B Suite 2300, Atlanta, GA 30322-1013 | 2008-06-10 |
1649479171 | Jeffrey W Wallace | Physician Assistant | 112 Piper Hill Dr, First Floor, Saint Peters, MO 63376-1690 | 2007-07-14 |
1215027990 | Jeffrey Wallace | Internal Medicine | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2006-10-13 |
1003866419 | Jeffrey Neil Wallace | Chiropractor | 330 140 Village Rd, Unit 9a, Westminster, MD 21157-6127 | 2006-05-10 |
Street Address |
400 S JEFFERSON ST STE 200 |
City | SPOKANE |
State | WA |
Zip Code | 99204-3143 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205193984 | Kelsey Nicole Clark | Counselor | 400 S Jefferson St Ste 200, Spokane, WA 99204-3143 | 2012-04-18 |
1053926337 | Tiffany Coury | Counselor | 400 S Jefferson St Ste 200, Spokane, WA 99204-3143 | 2020-09-13 |
1811519879 | Lindsey C Mcintyre | Social Worker | 400 S Jefferson St Ste 200, Spokane, WA 99204-3143 | 2020-05-13 |
1962973826 | Jenny L Finley | Counselor | 400 S Jefferson St Ste 200, Spokane, WA 99204-3143 | 2018-12-17 |
1124534474 | Debra Winter | Counselor | 400 S Jefferson St Ste 200, Spokane, WA 99204-3143 | 2017-12-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
Find all providers in zip 99204 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043819550 | Ginger Lee Grey | Counselor | 1325 W 1st Ave Ste 314, Spokane, WA 99201-4135 | 2020-10-26 |
1942808530 | Hannah M. Smith | Counselor | 106 W. Mission Ave, Spokane, WA 99201-2337 | 2020-10-15 |
1659979870 | Lisa Dawn Olson | Counselor | 327 W Montgomery Ave, Spokane, WA 99205-4737 | 2020-10-09 |
1811594658 | Kaaren Goeller-bloom | Counselor | 106 West Mission, Spokane, WA 99201 | 2020-10-05 |
1255946695 | Erik Brian Hildahl | Counselor | 514 E 22nd Ave, Spokane, WA 99203-2334 | 2020-09-12 |
1104439934 | Kristin Penn, Ma, Lmhc (pllc) | Counselor | 170 S Lincoln St Ste 150, Spokane, WA 99201-4443 | 2020-08-31 |
1740819416 | Elizabeth Michele Wright | Counselor | 815 W 7th Ave Ste 200, Spokane, WA 99204-2839 | 2020-04-05 |
1609416890 | Mychal Ferger | Counselor | 1411 W Garland Ave Ste A, Spokane, WA 99205-2614 | 2020-01-15 |
1922659630 | Creative Harmony Counseling LLC | Counselor | 721 N Pines Road, Spokane, WA 99206 | 2019-09-24 |
1447711668 | Elizabeth Cynthia Young | Counselor | 8727 Us-2, Spokane, WA 99224 | 2019-03-29 |
Find all providers in SPOKANE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.