Healthcare Provider Details

I. General information

NPI: 1093219495
Provider Name (Legal Business Name): BRENNAN MERRILL WRIGHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 5TH AVE
SPOKANE WA
99202-1334
US

IV. Provider business mailing address

400 E 5TH AVE
SPOKANE WA
99202-1334
US

V. Phone/Fax

Practice location:
  • Phone: 509-724-4300
  • Fax:
Mailing address:
  • Phone: 509-724-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number61400316
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number61400316
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: