Provider Demographics
NPI:1508529348
Name:OVERSTREET, TRINA MARIE
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:MARIE
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 N MORTON ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2683
Mailing Address - Country:US
Mailing Address - Phone:509-954-4064
Mailing Address - Fax:
Practice Address - Street 1:300 N ARGONNE RD STE 204
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2839
Practice Address - Country:US
Practice Address - Phone:208-699-2595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician