Provider Demographics
NPI:1598465056
Name:GILL, DOROTHY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DOTTIE
Other - Middle Name:
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:522 W RIVERSIDE AVE STE 5188
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0580
Mailing Address - Country:US
Mailing Address - Phone:509-730-5655
Mailing Address - Fax:
Practice Address - Street 1:522 W RIVERSIDE AVE STE 5188
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0580
Practice Address - Country:US
Practice Address - Phone:509-730-5655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPSYC.PY.61357274103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical