Individual
BROOKE EMMA ANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4011 TALBOT RD S STE 300, RENTON, WA 98055
(425) 656-5060
(425) 656-5047
Mailing address
4011 TALBOT RD S STE 300, RENTON, WA 98055-5791
(425) 656-5060
(425) 656-5047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
020306
NY
363AS0400X
Surgical Physician Assistant
Primary
PA60854540
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104406
—
WA
Enumeration date
11/22/2016
Last updated
10/02/2018
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