Provider Demographics
NPI:1740783398
Name:NORTHWEST FAMILY ADVOCATES
Entity Type:Organization
Organization Name:NORTHWEST FAMILY ADVOCATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:KIENHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED COUNSELOR
Authorized Official - Phone:509-326-8875
Mailing Address - Street 1:319 W HASTINGS RD STE A110
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-5021
Mailing Address - Country:US
Mailing Address - Phone:509-953-4461
Mailing Address - Fax:
Practice Address - Street 1:319 W HASTINGS RD STE A110
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-5021
Practice Address - Country:US
Practice Address - Phone:509-326-8875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL60164738101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty