Provider Demographics
NPI:1285681254
Name:BRANCHAUD, ANN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:BRANCHAUD
Suffix:
Gender:F
Credentials:MD
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 34584
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1584
Mailing Address - Country:US
Mailing Address - Phone:800-459-9034
Mailing Address - Fax:509-241-7628
Practice Address - Street 1:1730 MINOR AVE
Practice Address - Street 2:SUITE 1400
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1404
Practice Address - Country:US
Practice Address - Phone:206-287-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000396092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8318586Medicaid
WAG875273Medicare PIN
WA8318586Medicaid
WAGAB33218Medicare PIN