Healthcare Provider Details

I. General information

NPI: 1275073447
Provider Name (Legal Business Name): BRIAN G ALTMAIER MSW, LICSWA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N MULLAN RD STE 200
SPOKANE VALLEY WA
99206-3793
US

IV. Provider business mailing address

200 N MULLAN RD STE 200
SPOKANE VALLEY WA
99206-3793
US

V. Phone/Fax

Practice location:
  • Phone: 509-730-5664
  • Fax:
Mailing address:
  • Phone: 509-730-5664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWIA.SC.61429049
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: