Provider Demographics
NPI:1528117512
Name:EARIN, L. JOLENE (MS)
Entity type:Individual
Prefix:MS
First Name:L.
Middle Name:JOLENE
Last Name:EARIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 N DIVISION ST
Mailing Address - Street 2:STE. 603
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1600
Mailing Address - Country:US
Mailing Address - Phone:509-467-4931
Mailing Address - Fax:509-464-2094
Practice Address - Street 1:4407 N DIVISION ST
Practice Address - Street 2:STE. 603
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1600
Practice Address - Country:US
Practice Address - Phone:509-467-4931
Practice Address - Fax:509-464-2094
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA76074651Medicare UPIN