Provider Demographics
NPI:1427386366
Name:VARNER, TRACY (LMCH)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:VARNER
Suffix:
Gender:F
Credentials:LMCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 S CEDAR ST
Mailing Address - Street 2:APT 6
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4066
Mailing Address - Country:US
Mailing Address - Phone:509-599-9902
Mailing Address - Fax:
Practice Address - Street 1:1125 S CEDAR ST
Practice Address - Street 2:APT 6
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4066
Practice Address - Country:US
Practice Address - Phone:509-599-9902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009201101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health