Provider Demographics
NPI:1568878346
Name:MERK, BRANDEY R (LMP)
Entity Type:Individual
Prefix:
First Name:BRANDEY
Middle Name:R
Last Name:MERK
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1659 BIRCHWOOD AVE
Mailing Address - Street 2:#45
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1309
Mailing Address - Country:US
Mailing Address - Phone:360-627-1233
Mailing Address - Fax:
Practice Address - Street 1:2811 AZALEA PL
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1226
Practice Address - Country:US
Practice Address - Phone:360-627-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60450760225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist