Individual
MS. STACEY LEANNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
715 S COWLEY ST STE 210, SPOKANE, WA 99202
(509) 473-6706
(509) 473-6704
Mailing address
PO BOX 2185, SPOKANE, WA 99210-2185
(509) 474-6842
(509) 474-6606
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA23097
CA
363A00000X
Physician Assistant
Primary
PA60449258
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2034728
—
WA
05
—
500669258
—
OR
Enumeration date
07/18/2013
Last updated
06/25/2025
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