Individual
KASSIDY NOELLE BRUGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 NW 12TH AVE STE 107, BATTLE GROUND, WA 98604-9141
(360) 723-0528
Mailing address
9704 NE 150TH AVE, VANCOUVER, WA 98682-2779
(360) 608-7578
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
PC61239792
WA
363A00000X
Physician Assistant
Primary
PA.PA.61689173
WA
376K00000X
Nurse's Aide
NC60791384
WA
Other
Enumeration date
01/04/2022
Last updated
06/16/2025
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