Provider Demographics
NPI:1033657010
Name:LESTER, BRANDON THOMAS (DC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:THOMAS
Last Name:LESTER
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 1:3119 CHIVE PL SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-2321
Mailing Address - Country:US
Mailing Address - Phone:360-271-8534
Mailing Address - Fax:360-300-2700
Practice Address - Street 1:1730 SE MILE HILL DR
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3512
Practice Address - Country:US
Practice Address - Phone:360-386-1144
Practice Address - Fax:360-300-2700
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60728284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor