Provider Demographics
NPI:1376322701
Name:BRENFLECK, QUINN HENDRICK (MA)
Entity Type:Individual
Prefix:
First Name:QUINN
Middle Name:HENDRICK
Last Name:BRENFLECK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 12TH AVE E APT 6
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-5161
Mailing Address - Country:US
Mailing Address - Phone:520-609-0693
Mailing Address - Fax:
Practice Address - Street 1:2366 EASTLAKE AVE E STE 402
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3394
Practice Address - Country:US
Practice Address - Phone:206-202-3133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101200000XBehavioral Health & Social Service ProvidersDrama Therapist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist