Healthcare Provider Details

I. General information

NPI: 1962785030
Provider Name (Legal Business Name): BRYAN KEITH KLEVEN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2011
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 E 29TH AVE
SPOKANE WA
99223-4806
US

IV. Provider business mailing address

2610 E 29TH AVE
SPOKANE WA
99223-4806
US

V. Phone/Fax

Practice location:
  • Phone: 509-535-3623
  • Fax: 509-535-8413
Mailing address:
  • Phone: 509-535-3623
  • Fax: 509-535-8413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00059479
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: