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NPI Code Detail

MEDICARE: ANTHONY WAYNE MCBRIDE MS

MEDICARE: ANTHONY WAYNE MCBRIDE MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLH60889760WA
2101YA0400XAddiction (Substance Use Disorder) CounselorCP 00000262WA

General Provider Information

NPI Number : 1700131307
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY WAYNE MCBRIDE MS
Provider Business Mailing Address
First Line : 107 S DIVISION ST
Second Line :
City : SPOKANE
State : WA
Zip : 99202-1510
Country : US
Telephone Number : 509-838-4651
Fax Number : 509-363-2762
Provider Business Practice Location Address
First Line : 124 E SHORT AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99202-1555
Country : US
Telephone Number : 509-838-4651
Fax Number : 509-363-2762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2012
Last Update Date : 10/25/2018

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