Provider Demographics
NPI:1326481375
Name:PEAK PERFORMANCE PSYCHIATRY & COUNSELING
Entity Type:Organization
Organization Name:PEAK PERFORMANCE PSYCHIATRY & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:REZNICEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-315-4142
Mailing Address - Street 1:1717 S RUSTLE ST
Mailing Address - Street 2:SUITE 212A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-2065
Mailing Address - Country:US
Mailing Address - Phone:509-315-4142
Mailing Address - Fax:509-242-0797
Practice Address - Street 1:1717 S RUSTLE ST
Practice Address - Street 2:SUITE 212A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-2065
Practice Address - Country:US
Practice Address - Phone:509-315-4142
Practice Address - Fax:509-242-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)