Provider Demographics
NPI:1245603877
Name:DAVE PERRY, MA, PLLC
Entity Type:Organization
Organization Name:DAVE PERRY, MA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:509-991-5110
Mailing Address - Street 1:1807 S STEEN RD
Mailing Address - Street 2:
Mailing Address - City:VERADALE
Mailing Address - State:WA
Mailing Address - Zip Code:99037-9252
Mailing Address - Country:US
Mailing Address - Phone:509-991-5110
Mailing Address - Fax:
Practice Address - Street 1:920 N ARGONNE RD
Practice Address - Street 2:SUITE 120D
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2721
Practice Address - Country:US
Practice Address - Phone:509-991-5110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60262187101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty