Provider Demographics
NPI:1780231209
Name:FIELD, KRYSTINA MARIE (MSW MHP LICSW)
Entity Type:Individual
Prefix:MS
First Name:KRYSTINA
Middle Name:MARIE
Last Name:FIELD
Suffix:
Gender:F
Credentials:MSW MHP LICSW
Other - Prefix:
Other - First Name:KRYSTINA
Other - Middle Name:MARIE
Other - Last Name:MCFADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:316 W BOONE AVE STE 850
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2353
Mailing Address - Country:US
Mailing Address - Phone:509-609-4974
Mailing Address - Fax:
Practice Address - Street 1:316 W BOONE AVE STE 850
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2353
Practice Address - Country:US
Practice Address - Phone:509-609-4974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WALW614692511041C0700X
WASC61084532104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No104100000XBehavioral Health & Social Service ProvidersSocial Worker