Provider Demographics
NPI:1699847939
Name:BRANDSMA, DONALD ALLEN (LMP)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:ALLEN
Last Name:BRANDSMA
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 DESERT MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-9787
Mailing Address - Country:US
Mailing Address - Phone:509-547-8580
Mailing Address - Fax:
Practice Address - Street 1:3400 W CLEARWATER AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2709
Practice Address - Country:US
Practice Address - Phone:509-737-0610
Practice Address - Fax:509-737-8731
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021370225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist