Provider Demographics
NPI:1164595716
Name:BASSETT, BRANDY (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:
Last Name:BASSETT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:SHELDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21618 NE 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-6808
Mailing Address - Country:US
Mailing Address - Phone:253-670-9054
Mailing Address - Fax:
Practice Address - Street 1:1229 MADISON ST STE 1500
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3591
Practice Address - Country:US
Practice Address - Phone:206-386-3592
Practice Address - Fax:206-386-6657
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003684235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7100233Medicaid