Provider Demographics
NPI:1578032330
Name:LANDRUS, JOSH
Entity Type:Individual
Prefix:MR
First Name:JOSH
Middle Name:
Last Name:LANDRUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7114 N FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4826
Mailing Address - Country:US
Mailing Address - Phone:208-750-5456
Mailing Address - Fax:
Practice Address - Street 1:1100 W MALLON AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99260-2043
Practice Address - Country:US
Practice Address - Phone:509-477-6684
Practice Address - Fax:509-477-6683
Is Sole Proprietor?:No
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health