Individual
BRANDI JO FAUDREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3908 10TH ST SE, PUYALLUP, WA 98374
(253) 848-5951
(253) 845-7073
Mailing address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
(253) 845-7073
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60878133
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA60878133
WA STATE LICENSE
WA
Enumeration date
02/04/2009
Last updated
10/04/2018
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