Provider Demographics
NPI:1780746859
Name:BRENDELL, MARLENE K (ARNP)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:K
Last Name:BRENDELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:WA
Mailing Address - Zip Code:99159-0190
Mailing Address - Country:US
Mailing Address - Phone:509-982-2614
Mailing Address - Fax:509-982-2159
Practice Address - Street 1:510 E. AMENDE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:WA
Practice Address - Zip Code:99159
Practice Address - Country:US
Practice Address - Phone:509-982-2614
Practice Address - Fax:509-982-2159
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA30005375207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine