DR. ANGELIQUE GRAYSON TINDALL (NPI# 1912997800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912997800 |
| Entity Type | Individual |
| Full Name | DR. ANGELIQUE GRAYSON TINDALL |
| Other Name | MS. EVELYN ANGELIQUE GRAYSON |
| Credential | PHD |
| Practice Address |
1120 N. Pines Suite C Spokane WA 99206-4942 |
| Mailing Address |
Po Box 30248 Spokane WA 99223-3004 |
| Practice Telephone | 5097684248 |
| Practice Fax Number | 5093430504 |
| Mailing Telephone | 5097684248 |
| Mailing Fax Number | 5093430504 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2009-04-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY00001825 | WA | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | PY00001825 | WA | Behavioral Health & Social Service Providers |
| N | 103TH0100X |
Psychologist Specialization: Health Service |
PY00001825 | WA | Behavioral Health & Social Service Providers |
| N | 103TR0400X |
Psychologist Specialization: Rehabilitation |
PY00001825 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LABOR & INDUSTRIES | 0165817 | 01 |
| Street Address |
1120 N. PINES SUITE C |
| City | SPOKANE |
| State | WA |
| Zip Code | 99206-4942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851913495 | Ea Healing Arts LLC | Acupuncturist | 210 N University Rd, Ste 200, Spokane Valley, WA 99206 | 2020-05-16 |
| 1922659630 | Creative Harmony Counseling LLC | Counselor | 721 N Pines Road, Spokane, WA 99206 | 2019-09-24 |
| 1477027092 | Hunter Badgley | Counselor | 721 N Pines Rd Ste 2, Spokane Valley, WA 99206 | 2019-01-16 |
| 1851880934 | Ryan Bushman | Dentist | 919 N Pines Rd, Spokane Valley, WA 99206 | 2018-05-04 |
| 1902307531 | Lois Jensen | Counselor | 3507 S. Spotted Rd., Spokane, WA 99206 | 2018-02-28 |
| 1295258804 | Melissa Ann Reamer | Speech-Language Pathologist | 2510 N. Pines Rd., Ste. 3, Spokane Valley, WA 99206 | 2017-07-25 |
| 1730619149 | Amanda Kathryn Fuchs | Counselor | 200 N Mullan Rd Ste 219, Spokane Valley, WA 99206 | 2017-06-18 |
| 1588105308 | Pine Ridge Management Wa LLC | Assisted Living Facility | 5615 West Umatilla, Spokane, WA 99206 | 2017-03-13 |
| 1427405893 | Sarah Winn | Counselor | 721 N Pines, Spokane Valley, WA 99206 | 2016-05-16 |
| 1134573199 | Elzbieta H Anderson | Acupuncturist | 210 N University Rd Ste 200, Spokane Valley, WA 99206 | 2016-04-15 |
| Find all providers in zip 99206 | ||||
| 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 |
| 1790773463 | Gregory J. Charboneau | Clinical Neuropsychologist | 3157 E. 17th Avenue, Spokane, WA 99223-5136 | 2005-10-07 |
| 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.