Provider Demographics
NPI:1619282092
Name:BRUNK, ANNALISA WEILER (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:ANNALISA
Middle Name:WEILER
Last Name:BRUNK
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N PEARL ST STE E
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-2938
Mailing Address - Country:US
Mailing Address - Phone:509-925-9861
Mailing Address - Fax:509-925-1277
Practice Address - Street 1:707 N PEARL ST STE E
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-2938
Practice Address - Country:US
Practice Address - Phone:509-925-9861
Practice Address - Fax:509-925-1277
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker