Individual
DR. ANGELIQUE GRAYSON TINDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1120 N. PINES, SUITE C, SPOKANE, WA 99206-4942
(509) 768-4248
(509) 343-0504
Mailing address
PO BOX 30248, SPOKANE, WA 99223-3004
(509) 768-4248
(509) 343-0504
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY00001825
WA
103T00000X
Psychologist
PY00001825
WA
103TH0100X
Health Service Psychologist
PY00001825
WA
103TR0400X
Rehabilitation Psychologist
PY00001825
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0165817
LABOR & INDUSTRIES
WA
Enumeration date
10/24/2005
Last updated
04/14/2009
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