Provider Demographics
NPI:1629787585
Name:BUSTER, SIENNA RUTH
Entity Type:Individual
Prefix:
First Name:SIENNA
Middle Name:RUTH
Last Name:BUSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10311 N WAIKIKI RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2538
Mailing Address - Country:US
Mailing Address - Phone:509-844-7254
Mailing Address - Fax:
Practice Address - Street 1:205 W HAWTHORNE RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2557
Practice Address - Country:US
Practice Address - Phone:509-777-3401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA100000318666Medicaid
WA106493346OtherCIGNA