Provider Demographics
NPI:1508612847
Name:BRAIN AND MEMORY HEALTH GROUP PLLC
Entity Type:Organization
Organization Name:BRAIN AND MEMORY HEALTH GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN-REDFERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-494-3554
Mailing Address - Street 1:4742 42ND AVE SW # 406
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4553
Mailing Address - Country:US
Mailing Address - Phone:425-494-3554
Mailing Address - Fax:206-538-2563
Practice Address - Street 1:4501 15TH AVE S STE 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1874
Practice Address - Country:US
Practice Address - Phone:425-494-3554
Practice Address - Fax:206-538-2563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty