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Individual

MR. BRIAN CLYDE SUNDQUIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
617 BENTON ST, OMAK, WA 98841-9636
(509) 422-7409
(509) 422-7471
Mailing address
617 BENTON ST, OMAK, WA 98841-9636
(509) 422-7409
(509) 422-7471

Taxonomy

Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
246QM0706X
Medical Technologist
Primary

Other

Enumeration date
03/25/2010
Last updated
03/25/2010
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