Individual
JONATHAN EATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2118 E SPRAGUE AVE, SPOKANE, WA 99202-3125
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG61320912
WA
104100000X
Social Worker
Primary
SC61619563
WA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/07/2022
Last updated
03/25/2025
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