Provider Demographics
NPI:1326482332
Name:HARRIS, BRENNA R (DO)
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:R
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:PO BOX 1247
Mailing Address - Street 2:MS 1322-2 EFM
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-0192
Mailing Address - Country:US
Mailing Address - Phone:253-697-5757
Mailing Address - Fax:253-697-1439
Practice Address - Street 1:825 SE BISHOP BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5537
Practice Address - Country:US
Practice Address - Phone:509-332-2517
Practice Address - Fax:509-334-9247
Is Sole Proprietor?:No
Enumeration Date:2013-04-21
Last Update Date:2021-07-07
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Provider Licenses
StateLicense IDTaxonomies
WAOP60769736207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine