Basic Information
Provider Information
NPI: 1568975456
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLER
FirstName: RIKKI
MiddleName: JAYNE
NamePrefix:  
NameSuffix:  
Credential: MS, LMFTA, LMHCA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 203 N WASHINGTON ST STE 300
Address2:  
City: SPOKANE
State: WA
PostalCode: 992010254
CountryCode: US
TelephoneNumber: 5094448888
FaxNumber:  
Practice Location
Address1: 15812 E INDIANA AVE
Address2:  
City: SPOKANE VALLEY
State: WA
PostalCode: 992161875
CountryCode: US
TelephoneNumber: 5094448200
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/14/2017
LastUpdateDate: 02/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XMG60908295WAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 
106S00000X  N    

No ID Information.


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