Individual
BRENDAN SELDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
12728 19TH AVE SE, SUITE 200, EVERETT, WA 98208-6526
(425) 225-2700
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004907
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8446312
—
WA
01
—
P00286191
RAILROAD MEDICARE
—
01
—
PA10004907
STATE LICENSE NUMBER
WA
Enumeration date
05/31/2006
Last updated
11/03/2016
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