Provider Demographics
NPI:1730760356
Name:JENNIFER VAN WEY PSYD PLLC
Entity type:Organization
Organization Name:JENNIFER VAN WEY PSYD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN WEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:509-606-3997
Mailing Address - Street 1:316 W BOONE AVE STE 656
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2346
Mailing Address - Country:US
Mailing Address - Phone:509-714-6082
Mailing Address - Fax:
Practice Address - Street 1:316 W BOONE AVE STE 656
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2346
Practice Address - Country:US
Practice Address - Phone:509-606-3997
Practice Address - Fax:509-747-4420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty