Provider Demographics
NPI:1558425280
Name:SIMCHUK, JANICE K (MS)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:K
Last Name:SIMCHUK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 W 2ND AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-4539
Mailing Address - Country:US
Mailing Address - Phone:509-458-5889
Mailing Address - Fax:509-624-1216
Practice Address - Street 1:906 W 2ND AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-4538
Practice Address - Country:US
Practice Address - Phone:509-458-5889
Practice Address - Fax:509-624-1216
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA7542OtherBLUE CROSS
WALH0006082OtherCOUNSELORS LISCENSE
WAE21976OtherREGENCE BLUE SHIELD