Basic Information
Provider Information
NPI: 1922032648
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ECHEVARRIA GONZALEZ
FirstName: ADALINA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CARTER
OtherFirstName: ADALINA
OtherMiddleName: E
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 2
Mailing Information
Address1: 17022 N GOLDEN DR
Address2:  
City: COLBERT
State: WA
PostalCode: 990059638
CountryCode: US
TelephoneNumber: 5094658875
FaxNumber:  
Practice Location
Address1: 4815 N ASSEMBLY ST
Address2:  
City: SPOKANE
State: WA
PostalCode: 992056185
CountryCode: US
TelephoneNumber: 5094347013
FaxNumber: 5094347113
Other Information
ProviderEnumerationDate: 07/10/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X6137PRY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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