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Individual

BRENDA R VAN FOSSEN

Active
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Individual

BRENDA R VAN FOSSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
291334
NY
208000000X
Pediatrics Physician
MD00043720
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0191866
STATE L&I
WA
05
8409245
WA
01
8939525
STATE CRIME VICTIMS
WA
Enumeration date
08/05/2006
Last updated
03/22/2018
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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