Provider Demographics
NPI:1700522349
Name:DO, BRANDON (RPH)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:DO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8511 MERIDIAN AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4142
Mailing Address - Country:US
Mailing Address - Phone:206-234-2243
Mailing Address - Fax:
Practice Address - Street 1:6414 NE BOTHELL WAY
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-4819
Practice Address - Country:US
Practice Address - Phone:425-486-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA390200000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy