Healthcare Provider Details

I. General information

NPI: 1104296250
Provider Name (Legal Business Name): TARYN LEE BRANNON MS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2015
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 S HOWARD ST STE 321
SPOKANE WA
99201-3816
US

IV. Provider business mailing address

107 S DIVISION ST
SPOKANE WA
99202-1510
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-4128
  • Fax: 509-838-4816
Mailing address:
  • Phone: 509-838-4651
  • Fax: 509-363-2762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60823455
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: