Provider Demographics
NPI:1558788240
Name:BRAJTBORD, NANCY HOUGHTON
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:HOUGHTON
Last Name:BRAJTBORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:IOLA
Other - Last Name:HOUGHTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 9TH AVE
Mailing Address - Street 2:BOX 359947
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2499
Mailing Address - Country:US
Mailing Address - Phone:206-744-1600
Mailing Address - Fax:206-744-1614
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:BOX 359947
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2499
Practice Address - Country:US
Practice Address - Phone:206-744-1600
Practice Address - Fax:206-744-1614
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60259560163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse