Provider Demographics
NPI:1841593761
Name:RIGNELL, BRANDON TIMOTHY (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:TIMOTHY
Last Name:RIGNELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14305 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-6097
Mailing Address - Country:US
Mailing Address - Phone:608-406-1111
Mailing Address - Fax:
Practice Address - Street 1:433 STATE ST S
Practice Address - Street 2:SUITE #3
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6615
Practice Address - Country:US
Practice Address - Phone:425-827-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60183190111N00000X
WI4708-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor