Provider Demographics
NPI:1609068881
Name:TRIPP, BRANDON MCKEITH (MAC, LMHC, SUDP, SAP)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:MCKEITH
Last Name:TRIPP
Suffix:
Gender:M
Credentials:MAC, LMHC, SUDP, SAP
Other - Prefix:
Other - First Name:BRANDON
Other - Middle Name:
Other - Last Name:TRIPP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MAC, LMHC, SUDP, SAP
Mailing Address - Street 1:5600 RAINIER AVE S STE C202
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2407
Mailing Address - Country:US
Mailing Address - Phone:425-374-1821
Mailing Address - Fax:206-327-9508
Practice Address - Street 1:5600 RAINIER AVE S STE C202
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2407
Practice Address - Country:US
Practice Address - Phone:425-374-1821
Practice Address - Fax:206-327-9508
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60038956101YA0400X
101YP2500X, 102X00000X
WA60636433101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist