Provider Demographics
NPI:1902549132
Name:PHILLIPS, SONIA MARIA (MSW)
Entity Type:Individual
Prefix:MISS
First Name:SONIA
Middle Name:MARIA
Last Name:PHILLIPS
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:PMG E WA PSYCHIATRIC CENTER
Mailing Address - Street 2:105 W 8TH AVENUE STE 450E
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204
Mailing Address - Country:US
Mailing Address - Phone:509-474-6920
Mailing Address - Fax:
Practice Address - Street 1:PMG E WA PSYCHIATRIC CENTER
Practice Address - Street 2:105 W 8TH AVENUE STE 450E
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204
Practice Address - Country:US
Practice Address - Phone:509-474-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61018902104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker