Provider Demographics
NPI:1558855791
Name:MCDONALD, BRENDAN ROARKE (DNP, ARNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:BRENDAN
Middle Name:ROARKE
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DNP, ARNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1720
Mailing Address - Country:US
Mailing Address - Phone:425-789-2000
Mailing Address - Fax:
Practice Address - Street 1:1424 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1720
Practice Address - Country:US
Practice Address - Phone:425-789-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60858419363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health