Provider Demographics
NPI:1265778674
Name:RALEIGH, ELIZABETH C (MSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:RALEIGH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 WEST WAVERLY PLACE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1206 N LINCOLN ST
Practice Address - Street 2:SUITE 101C
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2559
Practice Address - Country:US
Practice Address - Phone:509-475-3581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW603051351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical