Provider Demographics
NPI:1134285968
Name:SPADARO, NINA IDA MARIE (EDD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:IDA MARIE
Last Name:SPADARO
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4945 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-9528
Mailing Address - Country:US
Mailing Address - Phone:304-319-4041
Mailing Address - Fax:888-972-8992
Practice Address - Street 1:4945 MISSION RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9528
Practice Address - Country:US
Practice Address - Phone:304-319-4041
Practice Address - Fax:888-972-8992
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60414032103T00000X
UT7464055-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist