Provider Demographics
NPI:1003226382
Name:NORTON, BRIAN (ATC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:NORTON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 PHYSICAL EDUCATION BUILDING
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-2476
Mailing Address - Country:US
Mailing Address - Phone:509-359-6971
Mailing Address - Fax:509-359-7388
Practice Address - Street 1:207 PHYSICAL EDUCATION BUILDING
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004-2476
Practice Address - Country:US
Practice Address - Phone:509-359-6971
Practice Address - Fax:509-359-7388
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1 600477432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer