Individual
SAMANTHA B BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
411 FORTUYN RD, GRAND COULEE, WA 99133-8718
(509) 633-1911
(509) 633-3644
Mailing address
411 FORTUYN RD, GRAND COULEE, WA 99133-8718
(509) 633-1911
(509) 633-3644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60233756
WA
363AS0400X
Surgical Physician Assistant
PA60233756
WA
Other
Enumeration date
09/14/2011
Last updated
10/01/2020
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