Provider Demographics
NPI:1962134403
Name:MOSTEK-GARLAND, STACEY COLLEEN (ARNP)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:COLLEEN
Last Name:MOSTEK-GARLAND
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:GARLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:468 W BASALT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-9073
Mailing Address - Country:US
Mailing Address - Phone:509-421-7518
Mailing Address - Fax:
Practice Address - Street 1:1337 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1136
Practice Address - Country:US
Practice Address - Phone:509-842-6093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61261005364SP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty