Provider Information for 1063496511
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Mr. BRYAN E STANFILL M.A.
Sex: Male
NPI: 1063496511
Last Updated: 2015-05-22
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1063496511 | ||||||||||||
| Enumeration Date | 2005-11-29 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 140 S ARTHUR ST SUITE 510 SPOKANE, WA 99202-2260 United States Phone: 509-326-6996 | Fax:509-328-9919 | ||||||||||||
| Primary Practice Address | 140 S ARTHUR ST SUITE 510 SPOKANE, WA 99202-2260 United States Phone: 509-326-6996 | Fax:509-328-9919 | ||||||||||||
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