Provider Demographics
NPI:1093750259
Name:OTTOSEN, DENISE K (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:K
Last Name:OTTOSEN
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 S GRAND BLVD STE 204N
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2200
Mailing Address - Country:US
Mailing Address - Phone:509-992-9800
Mailing Address - Fax:509-315-9825
Practice Address - Street 1:1403 S GRAND BLVD STE 204N
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2200
Practice Address - Country:US
Practice Address - Phone:509-992-9800
Practice Address - Fax:509-315-9825
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1093750259Medicaid