Provider Demographics
NPI:1093356628
Name:BROYLES, LOREN SCOTT (PEER SUPPORT COUNSEL)
Entity Type:Individual
Prefix:MR
First Name:LOREN
Middle Name:SCOTT
Last Name:BROYLES
Suffix:
Gender:M
Credentials:PEER SUPPORT COUNSEL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 W BOONE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2525
Mailing Address - Country:US
Mailing Address - Phone:509-325-7232
Mailing Address - Fax:
Practice Address - Street 1:910 W BOONE AVE STE 201
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2525
Practice Address - Country:US
Practice Address - Phone:509-325-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist