Provider Demographics
NPI:1760536239
Name:PAULLIN, CARLA A (MA)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:A
Last Name:PAULLIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 E HARTSON AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1343
Mailing Address - Country:US
Mailing Address - Phone:509-435-1168
Mailing Address - Fax:509-924-7759
Practice Address - Street 1:405 E HARTSON AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1343
Practice Address - Country:US
Practice Address - Phone:509-435-1168
Practice Address - Fax:509-924-7759
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00003901101YA0400X
WALH00008415101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health