Individual
MR. GRANT BURSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5316 E SUMAC LN, SPOKANE, WA 99223-5090
(206) 616-4001
Mailing address
5316 E SUMAC LN, SPOKANE, WA 99223-5090
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/14/2016
Last updated
08/28/2017
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