Provider Demographics
NPI:1225768591
Name:MCCONNELL, SIERRA KAYE
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:KAYE
Last Name:MCCONNELL
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 1:9118 E COLUMBIA DR APT A303
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-1756
Mailing Address - Country:US
Mailing Address - Phone:712-389-4546
Mailing Address - Fax:
Practice Address - Street 1:9118 E COLUMBIA DR APT A303
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-1756
Practice Address - Country:US
Practice Address - Phone:712-389-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker