Healthcare Provider Details

I. General information

NPI: 1427093269
Provider Name (Legal Business Name): BRIAN MICHAEL NEWMAN PHD ATC CNS CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3212 HEIGHTS DR
BELLINGHAM WA
98226-4244
US

IV. Provider business mailing address

3212 HEIGHTS DR
BELLINGHAM WA
98226-4244
US

V. Phone/Fax

Practice location:
  • Phone: 360-393-5702
  • Fax:
Mailing address:
  • Phone: 360-393-5702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: