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NPI Code Detail

MEDICARE: MIND BODY SOUL PSYCHIATRY PLLC

MEDICARE: MIND BODY SOUL PSYCHIATRY PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1659230241
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIND BODY SOUL PSYCHIATRY PLLC
Provider Business Mailing Address
First Line : 1111 E WESTVIEW CT STE C
Second Line :
City : SPOKANE
State : WA
Zip : 99218-1376
Country : US
Telephone Number : 509-594-6771
Fax Number : 949-695-4395
Provider Business Practice Location Address
First Line : 1111 E WESTVIEW CT STE C
Second Line :
City : SPOKANE
State : WA
Zip : 99218-1376
Country : US
Telephone Number : 509-594-6771
Fax Number : 949-695-4395
Authorized Official
Title or Position : OWNER
Name : KRISTY BROOTEN
Credential : MSN, ARNP, PMHNP-BC
Telephone Number : 509-594-6771
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “MIND BODY SOUL PSYCHIATRY PLLC ” Practice Location

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