NPI 1396218566

Brian Tyrell White

Practitioner Peer Specialist Omak, WA

Practice location

Address: 1007 Koala Dr, Omak, WA 98841-9247
Phone: (509) 826-6191
Fax: (509) 826-3029

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence CG60878786 (WA)

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Registry record

NPI: 1396218566
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Jan 2019
Record last updated: 9 Jan 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.