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Individual

DR. KIM B. BRANDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3900 CAPITOL MALL DR SW, OLYMPIA, WA 98502-8654
(360) 754-5858
Mailing address
5101 BRENNER RD NW, OLYMPIA, WA 98502-1534
(319) 329-8908

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00045715
WA
207Q00000X
Family Medicine Physician
20279
IA
207Q00000X
Family Medicine Physician
MD00045715
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0236140
LIWA VCR
WA
05
1012308
WA
01
3076BR
BSWA
WA
05
8444226
WA
01
P00626487
RRGA
WA
Enumeration date
06/14/2006
Last updated
08/24/2010
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