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Organization

THE N.A.T.I.V.E. PROJECT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TONI LODGE (EXECUTIVE DIRECTOR)
(509) 325-5502
Entity
Organization

Contact information

Practice address
1803 W MAXWELL AVE, SPOKANE, WA 99201-2831
(509) 325-5502
(509) 325-9839
Mailing address
1803 W MAXWELL AVE, SPOKANE, WA 99201-2831
(509) 325-5502
(509) 325-9839

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
32055600
WA
101YM0800X
Mental Health Counselor
184
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003480
WA
Enumeration date
10/12/2006
Last updated
01/07/2016
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