Provider Demographics
NPI:1083729651
Name:MATHER, BRIAN A (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:A
Last Name:MATHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 E WESTVIEW CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1319
Mailing Address - Country:US
Mailing Address - Phone:509-465-8400
Mailing Address - Fax:509-465-8500
Practice Address - Street 1:11909 N DIVISION ST
Practice Address - Street 2:STE 103
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1903
Practice Address - Country:US
Practice Address - Phone:509-465-8400
Practice Address - Fax:509-465-8500
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3336111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB32619Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER