Individual
DR. RICHARD BRANTNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 491-9480
Mailing address
PO BOX 5007, LACEY, WA 98509-5007
(800) 599-0166
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00039608
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0659BR
REGENCE BS
—
01
—
168556
WA L & I
—
05
—
268756
—
OR
05
—
8282097
—
WA
01
—
8935575
WA CRIME VICTIMS
—
01
—
A002
CHAMPUS
—
01
—
G62636
GROUP HEALTH
—
Enumeration date
05/30/2006
Last updated
07/08/2007
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