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Individual

MR. KEITH ALAN BRYANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
107 S DIVISION ST, SPOKANE, WA 99202
(509) 838-4651
(509) 363-2762
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
(509) 363-2762

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00001093
WA
104100000X
Social Worker
Primary
LW60150722
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1417077249
WA
Enumeration date
03/29/2007
Last updated
01/25/2022
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