Healthcare Provider Details

I. General information

NPI: 1790114353
Provider Name (Legal Business Name): BRIAN PHILLIP KARNS LMP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E HASTINGS RD
SPOKANE WA
99218-4901
US

IV. Provider business mailing address

2136 W RIVERSIDE AVE APT 113
SPOKANE WA
99201-1444
US

V. Phone/Fax

Practice location:
  • Phone: 509-340-3303
  • Fax:
Mailing address:
  • Phone: 509-294-3322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60352761
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: