Provider Demographics
NPI:1558673533
Name:PATHWAYS CHILDREN'S SERVICES
Entity Type:Organization
Organization Name:PATHWAYS CHILDREN'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:208-699-2595
Mailing Address - Street 1:708 N ARGONNE RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2700
Mailing Address - Country:US
Mailing Address - Phone:208-699-2595
Mailing Address - Fax:208-667-2794
Practice Address - Street 1:708 N ARGONNE RD
Practice Address - Street 2:SUITE 11
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2700
Practice Address - Country:US
Practice Address - Phone:208-699-2595
Practice Address - Fax:208-667-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6063071103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty