Provider Demographics
NPI:1619135589
Name:HENKEL, BRETT ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ERIC
Last Name:HENKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 N JEFFERSON LN STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-7104
Mailing Address - Country:US
Mailing Address - Phone:509-625-3700
Mailing Address - Fax:509-625-3747
Practice Address - Street 1:546 N JEFFERSON LN STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-7104
Practice Address - Country:US
Practice Address - Phone:509-625-3700
Practice Address - Fax:509-625-3747
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60041550207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAFH1299557OtherDEA
WA1154414761OtherGROUP NPI NUMBER
WAMD60041550OtherMEDICAL LICENSE