Provider Demographics
NPI:1568593317
Name:SPRADLIN, KELSEY R
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:R
Last Name:SPRADLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 W. FRANCIS
Mailing Address - Street 2:SUITE F
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205
Mailing Address - Country:US
Mailing Address - Phone:509-990-1720
Mailing Address - Fax:866-728-4836
Practice Address - Street 1:201 W. FRANCIS
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205
Practice Address - Country:US
Practice Address - Phone:509-990-1720
Practice Address - Fax:866-728-4836
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALH60180413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health