Provider Demographics
NPI:1730261785
Name:GILMAN, BRYCE HUNTER (DO)
Entity type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:HUNTER
Last Name:GILMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1414 N VERCLER RD
Mailing Address - Street 2:STE 4
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1092
Mailing Address - Country:US
Mailing Address - Phone:509-924-4681
Mailing Address - Fax:509-922-7634
Practice Address - Street 1:1414 N VERCLER RD BLDG 4
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1092
Practice Address - Country:US
Practice Address - Phone:509-924-4681
Practice Address - Fax:509-922-7634
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42514207Q00000X
WAOP 60015374207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8513491Medicaid
WA0236583OtherLABOR & INDUSTRIES
WA8513491Medicaid