Healthcare Provider Details
I. General information
NPI: 1386709012
Provider Name (Legal Business Name): SANDRA JANE BREMNER-DEXTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/22/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
906 W 2ND AVE SUITE 600
SPOKANE WA
99201-4538
US
IV. Provider business mailing address
906 W 2ND AVE SUITE 600
SPOKANE WA
99201-4538
US
V. Phone/Fax
- Phone: 509-458-5889
- Fax: 509-624-1216
- Phone: 509-458-5889
- Fax: 509-624-1216
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD00033557 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: