Brian Wade Brunck, P.A.-C.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA10005071 Issued in WA

Practice address

820 S McClellan St
Suite 300
Spokane, WA 99204-2457

Phone

(509) 838-7100

Fax

(509) 838-0721

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1184723082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S MCCLELLAN ST",
            "address_2": "SUITE 300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042457",
            "telephone_number": "509-838-7100",
            "fax_number": "509-838-0721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 E Central Ave Ste 440",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992086290",
            "country_code": "US",
            "telephone_number": "509-252-1977",
            "fax_number": "509-465-3026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNCK",
        "first_name": "BRIAN",
        "middle_name": "WADE",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10005071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8466344",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbrunck219116@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "212 E Central Ave Ste 440",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992086290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kate Bruhjell
• Natalie Rose Brulotte, FNP, ARNP, RN
• Cody Brumbelow, LMHCA
• Jennifer Nmi Brumblay-Dailey, RPH
• Catherine Marie Brumfield, RN
• Samuel Robert Brune, MOT
• Bethany Ann Bruner
• Susan KS Bruner, ARNP
• Richard S Brunkan, MD
• Emma Brunner, DPT

• Surgical Physician Assistant in Spokane, WA
• Providers in Spokane, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.