Provider Demographics
NPI:1225814585
Name:FORTITUDE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:FORTITUDE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:KAREY
Authorized Official - Middle Name:NEBO
Authorized Official - Last Name:KANANDA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:208-659-9382
Mailing Address - Street 1:23403 E MISSION AVE STE 200D
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7575
Mailing Address - Country:US
Mailing Address - Phone:208-261-2501
Mailing Address - Fax:877-935-2721
Practice Address - Street 1:23403 E MISSION AVE STE 200D
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7575
Practice Address - Country:US
Practice Address - Phone:208-261-2501
Practice Address - Fax:877-935-2721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty