Provider Demographics
NPI:1629183538
Name:BALDWIN, DEBORAH S (PHD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S ARTHUR ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2220
Mailing Address - Country:US
Mailing Address - Phone:509-456-2500
Mailing Address - Fax:509-456-2502
Practice Address - Street 1:140 S ARTHUR ST
Practice Address - Street 2:SUITE 410
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2220
Practice Address - Country:US
Practice Address - Phone:509-456-2500
Practice Address - Fax:509-456-2502
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1506103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0200539OtherDEPT OF LABOR & INDUSTRIE
WAG8865127Medicare PIN