Individual
MR. BRAD MITCHELL SECREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.P.
Contact information
Practice address
9720 N NEVADA ST, SPOKANE, WA 99218-3412
(509) 464-2273
(509) 242-1854
Mailing address
8612 E ROWAN LN, SPOKANE, WA 99217-9237
(509) 464-2273
(509) 242-1954
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00016543
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00016543
STATE LICENSE
WA
Enumeration date
12/08/2005
Last updated
07/08/2007
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