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General NPI Number Information
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NPI Number | 1225620966
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Entity Type | Individual
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Provider Name | MYLES CULVER HUSTAD
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Gender | Male
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 5306 93RD PL SW
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City | MUKILTEO
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State | WA
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Zip | 98275-3610
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Country | US
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Telephone | 509-934-4005
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Fax | 509-934-4006
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Provider Business Mailing Address
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Address Line | 100 N HOWARD ST STE R
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City | SPOKANE
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State | WA
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Zip | 99201-0508
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Country | US
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Telephone | 509-934-4005
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Fax | 509-934-4006
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 12868160-3902
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MK61645925
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License Number State | WA
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