Provider Demographics
NPI:1477854578
Name:HIGGINS, JEANETTE (PSYD)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W RIVERSIDE AVE
Mailing Address - Street 2:STE. 310
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:421 W RIVERSIDE AVE
Practice Address - Street 2:STE. 310
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0405
Practice Address - Country:US
Practice Address - Phone:509-456-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60183391103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical