Provider Demographics
NPI:1306841960
Name:VOLWILER, DARRELLE MORGAN (PHD)
Entity Type:Individual
Prefix:
First Name:DARRELLE
Middle Name:MORGAN
Last Name:VOLWILER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15308 W BLUEGRASS RD
Mailing Address - Street 2:
Mailing Address - City:NINE MILE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:99026-9604
Mailing Address - Country:US
Mailing Address - Phone:509-464-2474
Mailing Address - Fax:
Practice Address - Street 1:910 N WASHINGTON ST
Practice Address - Street 2:STE 211
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2260
Practice Address - Country:US
Practice Address - Phone:509-242-0806
Practice Address - Fax:509-325-4988
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002404103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAS96580Medicare UPIN
WAGAB13165Medicare PIN