=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306538509
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STACEY GARLAND PMHNP-BC PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2023
-----------------------------------------------------
Last Update Date | 04/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1337 S GRAND BLVD
-----------------------------------------------------
City | SPOKANE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99202-1136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-842-6093
-----------------------------------------------------
Fax | 509-357-8572
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 468 W BASALT RIDGE DR
-----------------------------------------------------
City | SPOKANE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99224-9073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER/OWNER
-----------------------------------------------------
Name | STACEY C MOSTEK-GARLAND
-----------------------------------------------------
Credential | PMHNP
-----------------------------------------------------
Telephone | 509-842-6093
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------