Individual
BROOKE GRANSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 W 8TH AVE STE 150E, SPOKANE, WA 99204
(509) 465-3919
(509) 277-7070
Mailing address
105 E 8TH AVE, SUITE 150E, SPOKANE, WA 99204-2318
(509) 465-3919
(509) 468-0705
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60997905
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/29/2018
Last updated
10/09/2019
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