Provider Demographics
NPI:1255482246
Name:LIPSCOMB, BRANDY (ND)
Entity Type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:
Last Name:LIPSCOMB
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:SULTAN
Mailing Address - State:WA
Mailing Address - Zip Code:98294-1568
Mailing Address - Country:US
Mailing Address - Phone:206-265-0399
Mailing Address - Fax:360-793-0214
Practice Address - Street 1:311 STEVENS AVENUE
Practice Address - Street 2:
Practice Address - City:SULTAN
Practice Address - State:WA
Practice Address - Zip Code:98284
Practice Address - Country:US
Practice Address - Phone:360-793-0206
Practice Address - Fax:360-793-0214
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT0001534175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath