Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ivy Raine Broadrick

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1336739820

Ivy Raine Broadrick is a Student in an Organized Health Care Education/Training Program in Spokane, Washington. Licensed in Washington. Registered with an NPI since 2021.

Licensed in
WA
In the registry since
2021
Specialties on file
3

Practice location Address checks out

107 S Division St
Spokane, WA 99202-1510
Phone: (509) 838-4651
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence MC61221129 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Counselor Taxonomy 101Y00000X · Licence CG61136424 (WA)

Record details

NPI number1336739820
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 19, 2021
Last updated in NPPESOctober 13, 2021
Certification dateOctober 13, 2021
Mailing address107 S Division St, Spokane, WA 99202-1510

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