Provider Demographics
NPI:1568560498
Name:BRENOWITZ, GENE L (MD)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:L
Last Name:BRENOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 PACIFIC AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-7900
Mailing Address - Country:US
Mailing Address - Phone:866-284-5033
Mailing Address - Fax:
Practice Address - Street 1:34515 9TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6761
Practice Address - Country:US
Practice Address - Phone:253-588-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025647207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8123663Medicaid
E72302Medicare UPIN
WA050040659Medicare PIN
WA8123663Medicaid
WAG000185008Medicare PIN