Provider Demographics
NPI:1003245432
Name:BRENNAN, KARA HARRINGTON (MSN, ARNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:HARRINGTON
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MSN, ARNP-BC
Other - Prefix:MS
Other - First Name:KARA
Other - Middle Name:MARGARET
Other - Last Name:HARRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, ARNP-BC
Mailing Address - Street 1:1520 EASTLAKE AVE E APT 324
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3942
Mailing Address - Country:US
Mailing Address - Phone:303-704-2270
Mailing Address - Fax:
Practice Address - Street 1:11522 NE 20TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3005
Practice Address - Country:US
Practice Address - Phone:425-462-2531
Practice Address - Fax:425-454-6176
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60427017363LA2200X, 364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1003245432Medicaid
G8927771OtherMEDICARE PTAN