Provider Demographics
NPI:1093580102
Name:CAZENAVE, KANDIS
Entity Type:Individual
Prefix:
First Name:KANDIS
Middle Name:
Last Name:CAZENAVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15510 S CURTIS RD
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-9517
Mailing Address - Country:US
Mailing Address - Phone:225-206-2624
Mailing Address - Fax:
Practice Address - Street 1:201 W NORTH RIVER DR STE 301
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2262
Practice Address - Country:US
Practice Address - Phone:509-903-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health