Provider Demographics
NPI:1942369764
Name:VAN WEY, JENNIFER (PSYD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:VAN WEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 W BOONE AVE
Mailing Address - Street 2:STE 656
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2346
Mailing Address - Country:US
Mailing Address - Phone:509-606-3997
Mailing Address - Fax:
Practice Address - Street 1:316 W BOONE AVE
Practice Address - Street 2:STE 656
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2346
Practice Address - Country:US
Practice Address - Phone:509-606-3997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00003323103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical