Provider Demographics
NPI:1396328365
Name:BRINKOPF & YANT PSYCHIATRIC SERVICES, PLLC
Entity type:Organization
Organization Name:BRINKOPF & YANT PSYCHIATRIC SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINKOPF
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP, PMHNP-BC
Authorized Official - Phone:253-466-3122
Mailing Address - Street 1:510 E MAIN STE D
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-5612
Mailing Address - Country:US
Mailing Address - Phone:253-466-3122
Mailing Address - Fax:253-256-7911
Practice Address - Street 1:510 E MAIN STE D
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-5612
Practice Address - Country:US
Practice Address - Phone:253-466-3122
Practice Address - Fax:253-256-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP60989967OtherSTATE ARNP LICENSE
WALP60921975OtherSTATE LPN LICENSE
PMHNP-BCOtherAMERICAN NURSES CREDENTIALING CENTER (ANCC)
WARN60622681OtherSTATE RN LICENSE
WARN60101504OtherSTATE RN LICENSE
WAAP60989620OtherSTATE ARNP LICENSE