DR. GREGORY J. CHARBONEAU (NPI# 1790773463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790773463 |
| Entity Type | Individual |
| Full Name | DR. GREGORY J. CHARBONEAU |
| Credential | EDD, BCN, BCB |
| Practice Address |
3157 E. 17th Avenue Spokane WA 99223-5136 |
| Practice Telephone | 5098388066 |
| Practice Fax Number | 8005948305 |
| Mailing Telephone | 5098388066 |
| Mailing Fax Number | 8005948305 |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2012-11-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | WA.LIC2046 | WA | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
2046 | WA | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
| N | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers | ||
| N | 103TH0004X |
Psychologist Specialization: Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| APA# | 80159590 | 01 |
| Street Address |
3157 E. 17TH AVENUE |
| City | SPOKANE |
| State | WA |
| Zip Code | 99223-5136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790253110 | The Anna Schindler Foundation Inc | Lodging | 2322 E 28th Ave, Spokane, WA 99223 | 2018-11-03 |
| 1174018113 | Taylor Bryant Etchart | Massage Therapist | 7040, 3209 E 57th Ave, Suite H, Spokane, WA 99223 | 2018-06-22 |
| 1366958415 | Jennifer Andrea Meroshnik | Massage Therapist | 3210 East 44th Ave, F301, Spokane, WA 99223 | 2017-12-26 |
| 1982060539 | Andrew John David Bingham | Nurse's Aide | 4202 S Regal St, Spokane, WA 99223 | 2016-01-12 |
| 1396118469 | Kerry Lee Traugott | Nurse Practitioner | 2405 E 17th Ave, Suite 113, Spokane, WA 99223 | 2015-11-11 |
| 1518335082 | Thomas Genthe | Psychologist | 5619 South Custer Rd., Spokane, WA 99223 | 2015-09-14 |
| 1346630035 | Inland Empire Therapy Associates | Occupational Therapist | 2527 E. 27th, Suite 100, Spokane, WA 99223 | 2015-02-02 |
| 1396080743 | Karin Lee Gilchrist | Dietitian, Registered | 3019 S. Lloyd Lane, Spokane, WA 99223 | 2012-12-11 |
| 1184968752 | Susan Marie Reynolds | Massage Therapist | 3010 S. Southeast Blvd, Suite A, Spokane, WA 99223 | 2012-11-20 |
| 1750638110 | Bobby E Kizer | Psychologist | 4219 E Prairie Lane Ct, Spokane, WA 99223 | 2012-08-04 |
| Find all providers in zip 99223 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528284783 | Frank M Rosekrans IIi | Clinical Neuropsychologist | 530 W Sinto, Spokane, WA 99201-2428 | 2007-04-17 |
| 1649310061 | Duane Green | Clinical Neuropsychologist | 105 W. Eighth Ave, Suite 408, Spokane, WA 99204-2318 | 2007-02-07 |
| 1396891818 | Ronald M Klein | Clinical Neuropsychologist | 601 W Main Ave, Suite 1011, Spokane, WA 99201-0636 | 2007-01-26 |
| 1962565184 | Allen Dean Bostwick | Clinical Neuropsychologist | 901 E 2nd Ave Ste 208, Spokane, WA 99202-2257 | 2006-12-18 |
| 1225143654 | Debra D Brown | Clinical Neuropsychologist | 522 W Riverside Ave, Suite 710, Spokane, WA 99201-0504 | 2006-08-19 |
| 1912997800 | Angelique Grayson Tindall | Clinical Neuropsychologist | 1120 N. Pines, Suite C, Spokane, WA 99206-4942 | 2005-10-24 |
| 1144212457 | Christine Richelle Guzzardo | Clinical Neuropsychologist | 421 W Riverside Ave, Suite 304, Spokane, WA 99201-0405 | 2005-08-22 |
| 1093194649 | Danielle Wald Baker | Clinical Neuropsychologist | 1303 N Division St, Suite A, Spokane, WA 99202-1930 | 2015-05-28 |
| 1508145731 | Alicia Faith Hegie | Clinical Neuropsychologist | 711 S Cowley St, Spokane, WA 99202-1388 | 2011-08-05 |
| 1922333863 | Erin Baldwin | Clinical Neuropsychologist | 400 E 5th Ave, Spokane, WA 99202-1334 | 2009-10-09 |
| Find all providers in SPOKANE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.