Provider Demographics
NPI:1700076189
Name:HANSEN, BRENDEN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDEN
Middle Name:LEE
Last Name:HANSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 N MAIN ST
Mailing Address - Street 2:WHIDBEY GENERAL HOSPITAL - MEDICAL STAFF OFFICE
Mailing Address - City:COUPEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98239-3413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 N MAIN ST
Practice Address - Street 2:WHIDBEY GENERAL HOSPITAL - MEDICAL STAFF OFFICE
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-3413
Practice Address - Country:US
Practice Address - Phone:360-678-7656
Practice Address - Fax:360-678-3507
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60145514207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine