Provider Demographics
NPI:1861600702
Name:DESCHANE, MONIQUE MARIE (MA)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:MARIE
Last Name:DESCHANE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 N PINES RD STE 210A
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6700
Mailing Address - Country:US
Mailing Address - Phone:509-922-6174
Mailing Address - Fax:509-922-6397
Practice Address - Street 1:1014 N PINES RD STE 210A
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6700
Practice Address - Country:US
Practice Address - Phone:509-922-6174
Practice Address - Fax:509-922-6397
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60065041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH60065041OtherWASHINGTON STATE DEPARTMENT OF HEALTH