Provider Demographics
NPI:1306712070
Name:GRUBB, SPENCER ALAN
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:ALAN
Last Name:GRUBB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21651 E COUNTRY VISTA DR STE F
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7709
Mailing Address - Country:US
Mailing Address - Phone:509-319-2310
Mailing Address - Fax:509-319-2341
Practice Address - Street 1:21651 E COUNTRY VISTA DR STE F
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7709
Practice Address - Country:US
Practice Address - Phone:509-319-2310
Practice Address - Fax:509-319-2341
Is Sole Proprietor?:No
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA70047927111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor