Provider Demographics
NPI:1801899109
Name:BARDWELL, DEBBIE (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:
Last Name:BARDWELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13074
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99213-3074
Mailing Address - Country:US
Mailing Address - Phone:509-263-3060
Mailing Address - Fax:509-448-0958
Practice Address - Street 1:920 N ARGONNE RD STE 207
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2721
Practice Address - Country:US
Practice Address - Phone:509-263-3060
Practice Address - Fax:509-448-0958
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 1117106H00000X
WAPY1721103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WABA8938OtherREGENCE BLUESHIELD
WAGAB14172Medicare ID - Type Unspecified
WABA8938OtherREGENCE BLUESHIELD