Provider Demographics
NPI:1083752257
Name:HARRISON, MARGARET JILL (MS)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:JILL
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:MADSEN KELLY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:1404 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-3502
Mailing Address - Country:US
Mailing Address - Phone:509-290-2649
Mailing Address - Fax:509-485-5101
Practice Address - Street 1:1404 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-3502
Practice Address - Country:US
Practice Address - Phone:509-290-2649
Practice Address - Fax:509-485-5101
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005498101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health