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Individual

BRANDON WILLEM VANDERWEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
19930 BALLINGER WAY NE, SHORELINE, WA 98155-1223
(425) 778-2220
Mailing address
1965 COULSTON ST APT 14, LOMA LINDA, CA 92354-1741

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD60786062
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD60786062
MEDICAL LICENSE
WA
Enumeration date
06/04/2013
Last updated
08/20/2019
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