Provider Demographics
NPI:1700217403
Name:NANETTE BRISBANE, O.D., PLLC
Entity type:Organization
Organization Name:NANETTE BRISBANE, O.D., PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:NANETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRISBANE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-443-3145
Mailing Address - Street 1:12209 E MISSION AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4824
Mailing Address - Country:US
Mailing Address - Phone:509-443-3145
Mailing Address - Fax:509-443-3968
Practice Address - Street 1:12209 E MISSION AVE STE 9
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4824
Practice Address - Country:US
Practice Address - Phone:509-443-3145
Practice Address - Fax:509-443-3968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty