Provider Demographics
NPI:1679686265
Name:HOWLETT, BRIAN ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANTHONY
Last Name:HOWLETT
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 1:428 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-1920
Mailing Address - Country:US
Mailing Address - Phone:509-758-4357
Mailing Address - Fax:509-758-9122
Practice Address - Street 1:428 5TH STREET
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-1920
Practice Address - Country:US
Practice Address - Phone:509-758-4357
Practice Address - Fax:509-758-9122
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2013605Medicaid
35004055OtherMEDICARE RR PALMETTO GBA
ID000010007092OtherREGENCE
WA0015388OtherLABOR & INDUSTRIES
35004055OtherMEDICARE RR PALMETTO GBA