Provider Demographics
NPI:1447673983
Name:IRWIN, BRENDAN (DC)
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:
Last Name:IRWIN
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 1:3324 S GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2619
Mailing Address - Country:US
Mailing Address - Phone:509-838-7973
Mailing Address - Fax:
Practice Address - Street 1:3324 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2619
Practice Address - Country:US
Practice Address - Phone:509-838-7973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2017-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHI 1584111N00000X
WACH60742216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor