Basic Information
| Provider Information | |||||||||
| NPI: | 1861767949 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EAGER | ||||||||
| FirstName: | PHILIP | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 203 N WASHINGTON ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992010233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094448888 | ||||||||
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| Practice Location | |||||||||
| Address1: | 924 S PINES RD | ||||||||
| Address2: | |||||||||
| City: | SPOKANE VALLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992065423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094340313 | ||||||||
| FaxNumber: | 5094448206 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2012 | ||||||||
| LastUpdateDate: | 03/21/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LH60135542 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.