Individual
BRENDA RENEE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13501 NE 28TH ST, VANCOUVER, WA 98682-8091
Mailing address
13501 NE 28TH ST, VANCOUVER, WA 98682-8091
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00047611
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245311141
—
WA
Enumeration date
03/27/2019
Last updated
03/27/2019
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