Provider Demographics
NPI:1609526151
Name:BRETT, SCOTT KENNEDY (NAC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:KENNEDY
Last Name:BRETT
Suffix:
Gender:M
Credentials:NAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15715 N HOWE RD
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:WA
Mailing Address - Zip Code:99021-9062
Mailing Address - Country:US
Mailing Address - Phone:509-808-5144
Mailing Address - Fax:702-224-2180
Practice Address - Street 1:15715 N HOWE RD
Practice Address - Street 2:
Practice Address - City:MEAD
Practice Address - State:WA
Practice Address - Zip Code:99021-9062
Practice Address - Country:US
Practice Address - Phone:509-808-5144
Practice Address - Fax:702-224-2180
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC61017496376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide