Provider Demographics
NPI:1376893230
Name:INLAND COMMUNICATION & REHAB ASSOCIATES
Entity Type:Organization
Organization Name:INLAND COMMUNICATION & REHAB ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:CLARE
Authorized Official - Last Name:MANZA
Authorized Official - Suffix:
Authorized Official - Credentials:SLP MS CCC
Authorized Official - Phone:509-993-5365
Mailing Address - Street 1:1111 E WESTVIEW CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1376
Mailing Address - Country:US
Mailing Address - Phone:509-993-5365
Mailing Address - Fax:509-465-1748
Practice Address - Street 1:1111 E WESTVIEW CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1376
Practice Address - Country:US
Practice Address - Phone:509-993-5396
Practice Address - Fax:509-465-1748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004128235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2017196Medicaid