Provider Demographics
NPI:1477520450
Name:CASSIDY-BRINN, MARIE VIRGINIA (ARNP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:VIRGINIA
Last Name:CASSIDY-BRINN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:GINNY
Other - Middle Name:
Other - Last Name:CASSIDY-BRINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:4300 TALBOT RD S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6238
Mailing Address - Country:US
Mailing Address - Phone:425-255-0471
Mailing Address - Fax:
Practice Address - Street 1:4300 TALBOT RD S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6238
Practice Address - Country:US
Practice Address - Phone:425-255-0471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP0002261363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health