Provider Demographics
NPI:1043230758
Name:CHANDLER, SAMANTHA SUSAN-MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:SUSAN-MARIE
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 E BRIDGEPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-4608
Mailing Address - Country:US
Mailing Address - Phone:509-880-5721
Mailing Address - Fax:
Practice Address - Street 1:905 W RIVERSIDE AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1016
Practice Address - Country:US
Practice Address - Phone:509-747-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002704103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist