Provider Demographics
NPI:1619164597
Name:PUTNAM, ROSANNE (MSW, CSW)
Entity Type:Individual
Prefix:
First Name:ROSANNE
Middle Name:
Last Name:PUTNAM
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:PUTNAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, CSW
Mailing Address - Street 1:PO BOX 18377
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99228
Mailing Address - Country:US
Mailing Address - Phone:509-954-0184
Mailing Address - Fax:
Practice Address - Street 1:1312 N MONROE ST
Practice Address - Street 2:SUITE 241
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2623
Practice Address - Country:US
Practice Address - Phone:509-954-0184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
WARC00057183104100000X
WALW 602131731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker