Provider Demographics
NPI:1083184675
Name:PASCHALL, ALICIA L
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:L
Last Name:PASCHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:LYNN
Other - Last Name:CAASBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1518 N MICHIGAN LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99016-9836
Mailing Address - Country:US
Mailing Address - Phone:509-981-1337
Mailing Address - Fax:
Practice Address - Street 1:4017 E 12TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5334
Practice Address - Country:US
Practice Address - Phone:509-981-1337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)