Individual
MR. BRIAN KEVIN TAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1130 W PRAIRIE AVE, COEUR D ALENE, ID 83815-8780
(208) 209-0288
(208) 209-0289
Mailing address
PO BOX 1517, PENDLETON, OR 97801-0410
(541) 278-4332
(541) 278-8349
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-2587
ID
363AM0700X
Medical Physician Assistant
PA60913443
WA
Other
Enumeration date
09/05/2017
Last updated
10/24/2023
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