Provider Demographics
NPI:1851681340
Name:BRONFERMAKHER, DEANNA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:BRONFERMAKHER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 NE 180TH ST STE 160
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-5778
Mailing Address - Country:US
Mailing Address - Phone:253-752-7320
Mailing Address - Fax:425-491-7543
Practice Address - Street 1:12900 NE 180TH ST STE 160
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-5778
Practice Address - Country:US
Practice Address - Phone:253-752-7320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401896363LP0808X
WAAP61411909363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health