Provider Demographics
NPI:1376011874
Name:VALLIES, EMILY ANN (CDPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:VALLIES
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 E PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1563
Mailing Address - Country:US
Mailing Address - Phone:509-570-8614
Mailing Address - Fax:
Practice Address - Street 1:715 E SPRAGUE AVE STE 107
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2142
Practice Address - Country:US
Practice Address - Phone:509-381-3235
Practice Address - Fax:509-309-3944
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60725462101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACO60725462OtherWASHINGTON STATE DEPARTMENT OF HEALTH