Provider Demographics
NPI:1376162537
Name:NORTHWEST SEXUAL COUNSELING
Entity Type:Organization
Organization Name:NORTHWEST SEXUAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ZITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NICKESON
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:509-868-3387
Mailing Address - Street 1:1616 W WELLESLEY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-1413
Mailing Address - Country:US
Mailing Address - Phone:509-868-3387
Mailing Address - Fax:509-381-5461
Practice Address - Street 1:1616 W WELLESLEY AVE STE B
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-1413
Practice Address - Country:US
Practice Address - Phone:509-868-3387
Practice Address - Fax:509-381-5461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty