Provider Demographics
NPI:1891174314
Name:BRANDLER, JUSTIN GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:GREGORY
Last Name:BRANDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:MS:C3-GAS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-223-2319
Mailing Address - Fax:206-341-1405
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:MS:C3-GAS
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-2319
Practice Address - Fax:206-341-1405
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN60685207R00000X
WAMD61297064207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine