Provider Demographics
NPI:1790836237
Name:DALKE, RICHARD V (MS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:V
Last Name:DALKE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 N K ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6563
Mailing Address - Country:US
Mailing Address - Phone:509-995-0721
Mailing Address - Fax:509-471-1948
Practice Address - Street 1:9212 N K ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6563
Practice Address - Country:US
Practice Address - Phone:509-995-0721
Practice Address - Fax:509-471-1948
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00004909101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health