Provider Demographics
NPI:1568574879
Name:BRANDSNESS, GERALD DALE (REGISTERED COUNSELOR)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:DALE
Last Name:BRANDSNESS
Suffix:
Gender:M
Credentials:REGISTERED COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 N 175TH ST
Mailing Address - Street 2:APT C203
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-5047
Mailing Address - Country:US
Mailing Address - Phone:206-546-9689
Mailing Address - Fax:
Practice Address - Street 1:4807 196TH ST SW
Practice Address - Street 2:SUITE 220
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036
Practice Address - Country:US
Practice Address - Phone:425-935-5850
Practice Address - Fax:425-835-5855
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00020249101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor