Provider Demographics
NPI:1396009130
Name:ALLMARAS, ANTHONY FREDERICK (MSW/LICSW)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:FREDERICK
Last Name:ALLMARAS
Suffix:
Gender:M
Credentials:MSW/LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1510
Mailing Address - Country:US
Mailing Address - Phone:509-838-4651
Mailing Address - Fax:509-363-2762
Practice Address - Street 1:107 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1510
Practice Address - Country:US
Practice Address - Phone:509-838-4651
Practice Address - Fax:509-363-2762
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23091041C0700X
WALW608621451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2106474Medicaid