Provider Demographics
NPI:1376128819
Name:CRABTREE, JULIEA
Entity Type:Individual
Prefix:
First Name:JULIEA
Middle Name:
Last Name:CRABTREE
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 1:11707 E SPRAGUE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6124
Mailing Address - Country:US
Mailing Address - Phone:509-999-5657
Mailing Address - Fax:
Practice Address - Street 1:11707 E SPRAGUE AVE STE 106
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6124
Practice Address - Country:US
Practice Address - Phone:509-999-5657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2024-03-05
Deactivation Date:2024-01-25
Deactivation Code:
Reactivation Date:2024-02-08
Provider Licenses
StateLicense IDTaxonomies
106S00000X
WASC615103071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician