Healthcare Provider Details

I. General information

NPI: 1538004379
Provider Name (Legal Business Name): DELAINEY BRYSON PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DELAINEY DERRICK

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18915 E APPLEWAY AVE
SPOKANE VALLEY WA
99016-8857
US

IV. Provider business mailing address

1610 N CIRQUE LN
LIBERTY LAKE WA
99016-5061
US

V. Phone/Fax

Practice location:
  • Phone: 512-799-8291
  • Fax:
Mailing address:
  • Phone: 512-799-8291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: