Individual
MRS. AUDREY WICKS BRANOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8810 2ND AVE NE, SEATTLE, WA 98115-2963
(360) 621-5562
Mailing address
8810 2ND AVE NE, SEATTLE, WA 98115-2963
(360) 621-5562
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.60595391
WA
Other
Enumeration date
09/14/2014
Last updated
02/08/2016
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