Provider Demographics
NPI:1588956338
Name:SEDLER, MICHAEL DEAN
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DEAN
Last Name:SEDLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 S WANETA RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-1938
Mailing Address - Country:US
Mailing Address - Phone:509-443-1605
Mailing Address - Fax:509-443-0111
Practice Address - Street 1:6505 S WANETA RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-1938
Practice Address - Country:US
Practice Address - Phone:509-443-1605
Practice Address - Fax:509-443-0111
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60153405104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker