IndividualActive
Gregory Charboneau, EDD, BCN, BCB
NPI 1790773463 · Clinical Neuropsychologist · Spokane, WA
Provider details
- NPI number
- 1790773463
- Entity type
- Individual
- Primary specialty
- Clinical NeuropsychologistBehavioral Health & Social Service Providers
- Credential
- EDD, BCN, BCB
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2046 (WA)
Practice location
3157 E. 17th Avenue
Spokane, WA 99223-5136
Phone: (509) 838-8066
Fax: (800) 594-8305
Mailing address
3157 E. 17th Avenue
Spokane, WA 99223-5136
Registry dates
- Enumerated
- 2005-10-07
- Last updated
- 2012-11-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.