Provider Demographics
NPI:1710098678
Name:ANDERSON, DENNIS WALTER (MS,LMHC)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:WALTER
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MS,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 W RIVERSIDE AVE STE 607
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1099
Mailing Address - Country:US
Mailing Address - Phone:509-744-0778
Mailing Address - Fax:509-344-0779
Practice Address - Street 1:905 W RIVERSIDE AVE STE 607
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1099
Practice Address - Country:US
Practice Address - Phone:509-744-0778
Practice Address - Fax:509-344-0779
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health