Provider Demographics
NPI:1962893628
Name:SPOKARE, LLC
Entity type:Organization
Organization Name:SPOKARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:STANKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:CDP
Authorized Official - Phone:509-534-5000
Mailing Address - Street 1:611 E 2ND AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-6010
Mailing Address - Country:US
Mailing Address - Phone:509-534-5000
Mailing Address - Fax:509-534-0288
Practice Address - Street 1:611 E 2ND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-6010
Practice Address - Country:US
Practice Address - Phone:509-534-5000
Practice Address - Fax:509-534-0288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60191424251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health