Provider Demographics
NPI:1396137972
Name:WABLE, HARLAND C (MS, SUDPC, LMHA)
Entity type:Individual
Prefix:
First Name:HARLAND
Middle Name:C
Last Name:WABLE
Suffix:
Gender:M
Credentials:MS, SUDPC, LMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 W GARLAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-2619
Mailing Address - Country:US
Mailing Address - Phone:509-389-3813
Mailing Address - Fax:509-325-7800
Practice Address - Street 1:1403 W GARLAND AVE STE A
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-2619
Practice Address - Country:US
Practice Address - Phone:509-389-3813
Practice Address - Fax:509-325-7800
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60488888101YM0800X
WACP00006115101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1952474405Medicaid