Provider Demographics
NPI:1700593795
Name:BRUNNER, PATRICIA MAY (MA-P)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MAY
Last Name:BRUNNER
Suffix:
Gender:F
Credentials:MA-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SHORT CUT RD
Mailing Address - Street 2:
Mailing Address - City:INCHELIUM
Mailing Address - State:WA
Mailing Address - Zip Code:99138
Mailing Address - Country:US
Mailing Address - Phone:509-722-7629
Mailing Address - Fax:509-722-7631
Practice Address - Street 1:39 SHORT CUT RD
Practice Address - Street 2:
Practice Address - City:INCHELIUM
Practice Address - State:WA
Practice Address - Zip Code:99138
Practice Address - Country:US
Practice Address - Phone:509-722-7629
Practice Address - Fax:509-722-7631
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other