Provider Demographics
NPI:1902574445
Name:PHELPS, BRANDI (DPT)
Entity type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:
Last Name:PHELPS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 W 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-4615
Mailing Address - Country:US
Mailing Address - Phone:423-315-6786
Mailing Address - Fax:
Practice Address - Street 1:1403 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2263
Practice Address - Country:US
Practice Address - Phone:509-624-4200
Practice Address - Fax:509-624-2817
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist