Individual
MRS. STACIA REAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, OSTEOPATHIC PA
Contact information
Practice address
124 E ROWAN AVE STE 101, SPOKANE, WA 99207-1214
(509) 487-6222
Mailing address
124 E ROWAN AVE STE 202, SPOKANE, WA 99207-1214
(509) 487-8000
(509) 487-6333
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OA60801269
WA
363A00000X
Physician Assistant
PA60790383
WA
Other
Enumeration date
05/26/2016
Last updated
05/15/2020
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