Provider Demographics
NPI:1689706632
Name:BRENNAN, NANCY LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LYNN
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6307 39TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1801
Mailing Address - Country:US
Mailing Address - Phone:206-938-7458
Mailing Address - Fax:206-938-7458
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-277-5509
Practice Address - Fax:206-764-2577
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13930-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist