BRIAN MIZOGUCHI (NPI# 1477828556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477828556 |
| Entity Type | Individual |
| Full Name | BRIAN MIZOGUCHI |
| Credential | CDP |
| Practice Address |
5921 N Market St Spokane WA 99208-2484 |
| Mailing Address |
203 N Washington St Ste 300 Spokane WA 99201-0233 |
| Practice Telephone | 5094871604 |
| Practice Fax Number | 5094826286 |
| Mailing Telephone | 5094448888 |
| Mailing Fax Number | 5094447806 |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2012-03-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CP60145164 | WI | Behavioral Health & Social Service Providers |
| Street Address |
5921 N MARKET ST |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-2484 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255325460 | Theresa Wiederhold | Nurse Practitioner | 5921 N Market St, Spokane, WA 99208-2484 | 2005-09-01 |
| 1316581465 | Community Health Association of Spokane | Pharmacy | 5921 N Market St, Spokane, WA 99208-2484 | 2019-11-01 |
| 1528526993 | Ryan Michael Lysne | Physician Assistant | 5921 N Market St, Spokane, WA 99208-2484 | 2019-03-05 |
| 1518475961 | Jennifer Patricia Loweree | Dietitian, Registered | 5921 N Market St, Spokane, WA 99208-2484 | 2018-01-19 |
| 1316478183 | Lich Pham | Family Medicine | 5921 N Market St, Spokane, WA 99208-2484 | 2017-03-23 |
| 1245773571 | Caitlin Miller | Physician Assistant | 5921 N Market St, Spokane, WA 99208 | 2016-11-17 |
| 1114476439 | Tamara Ganahl | Nurse Practitioner | 5921 N Market St, Spokane, WA 99208-2484 | 2016-09-28 |
| 1003218389 | Jeffrey Hayward | Physician Assistant | 5921 N Market St, Spokane, WA 99208-2484 | 2014-09-18 |
| 1942620307 | Joshua Raymond Kistner | Family Medicine | 5921 N Market St, Spokane, WA 99208 | 2014-04-23 |
| 1477856144 | Community Health Association of Spokane | Pharmacy | 5921 N Market St, Spokane, WA 99208-2484 | 2010-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517952 | Maria Escobedo | Counselor | 1321 N. Ash, Spokane, WA 99201 | 2020-10-29 |
| 1295342111 | Pamela Sue Russo | Counselor | 103 E First Ave, Spokane, WA 99202-1510 | 2020-09-24 |
| 1033728415 | Beyond Behavioral Health LLC | Counselor | 104 S Freya St Bldg Suite210, Spokane, WA 99202-4862 | 2020-07-30 |
| 1700400702 | Heather Hedum | Counselor | 104 S Freya St Ste 206, Spokane, WA 99202-4889 | 2020-06-04 |
| 1568004182 | Tracy L Dantzler | Counselor | 101 E Magnesium Rd Ste 101, Spokane, WA 99208-5901 | 2019-10-15 |
| 1568921534 | Megan Nicole Tackes | Counselor | 1508 W 6th Ave, Spokane, WA 99204-3409 | 2019-03-18 |
| 1942772637 | Cheryl Kay Cross | Counselor | 4214 N Cedar St, Spokane, WA 99205-1323 | 2018-12-19 |
| 1508337361 | Lisa Webb | Counselor | 2402 E Nebraska Ave, Spokane, WA 99208-2308 | 2018-12-05 |
| 1881162956 | Adam Patyk | Counselor | 820 W Jackson Ave Apt 3, Spokane, WA 99205-3335 | 2018-11-07 |
| 1003383159 | Sandra Kay Robinson | Counselor | New Horizons Care Centers, Inc., 701 E 3rd Street, Spokane, WA 99201 | 2018-10-26 |
| Find all providers in SPOKANE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.