Provider Demographics
NPI:1871183046
Name:MILES, CASSANDRA S
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:S
Last Name:MILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 N DIVISION ST STE M3
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1554
Mailing Address - Country:US
Mailing Address - Phone:503-877-3351
Mailing Address - Fax:
Practice Address - Street 1:9507 N DIVISION ST STE M3
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1554
Practice Address - Country:US
Practice Address - Phone:509-253-1253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC615721191041C0700X
WACG61263436175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical