Provider Demographics
NPI:1942505060
Name:SOLBERG, STACI LYNN (MS)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:LYNN
Last Name:SOLBERG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:STACI
Other - Middle Name:LYNN
Other - Last Name:KEISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:25 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4601
Mailing Address - Country:US
Mailing Address - Phone:509-328-1582
Mailing Address - Fax:877-376-3335
Practice Address - Street 1:25 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4601
Practice Address - Country:US
Practice Address - Phone:509-328-1582
Practice Address - Fax:877-376-3335
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor