Provider Demographics
NPI:1205462058
Name:ARNOLD, NATASHA LYNN (SUDP-T)
Entity type:Individual
Prefix:MISS
First Name:NATASHA
Middle Name:LYNN
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:SUDP-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 N FOX RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4924
Mailing Address - Country:US
Mailing Address - Phone:509-919-8888
Mailing Address - Fax:
Practice Address - Street 1:1321 N ASH ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2803
Practice Address - Country:US
Practice Address - Phone:509-327-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61045591101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)