Basic Information
Provider Information
NPI: 1538716071
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WINTER
FirstName: MORGAN
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential: BA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 107 S DIVISION ST
Address2:  
City: SPOKANE
State: WA
PostalCode: 992021510
CountryCode: US
TelephoneNumber: 5098384651
FaxNumber: 5093632762
Practice Location
Address1: 711 E 3RD AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992022211
CountryCode: US
TelephoneNumber: 5098384651
FaxNumber: 5093632762
Other Information
ProviderEnumerationDate: 08/20/2019
LastUpdateDate: 04/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000XCG60965667WAN Student, Health CareStudent in an Organized Health Care Education/Training Program 
101Y00000XCG60995667WAY Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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