Provider Demographics
NPI:1295712651
Name:BRAWER, MICHAEL K (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:K
Last Name:BRAWER
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 1:1570 N 115TH ST
Mailing Address - Street 2:SUITE PB 15
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8412
Mailing Address - Country:US
Mailing Address - Phone:206-368-6591
Mailing Address - Fax:206-368-1191
Practice Address - Street 1:1570 N 115TH ST
Practice Address - Street 2:SUITE PB 15
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8412
Practice Address - Country:US
Practice Address - Phone:206-368-6591
Practice Address - Fax:206-368-1191
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00026431208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8202814Medicaid
WAMD00026431OtherMD LICENSE
WA8202814Medicaid
WAGABO3277Medicare PIN