Provider Demographics
NPI:1841781903
Name:WINES, CATHERINE MARIE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:WINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3924 S LEE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-4160
Mailing Address - Country:US
Mailing Address - Phone:509-509-7784
Mailing Address - Fax:509-721-7740
Practice Address - Street 1:2211 N MONROE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-4546
Practice Address - Country:US
Practice Address - Phone:509-992-7454
Practice Address - Fax:509-721-7740
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60846087101YM0800X, 106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health