Individual
TED A. BRANSTETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 773-2332
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA10003588
WA
363AS0400X
Surgical Physician Assistant
Primary
10707
AZ
363AS0400X
Surgical Physician Assistant
PA10003588
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16675551
MEDICARE PTAN
ID
05
—
805045200
—
ID
05
—
8374811
—
WA
01
—
G8871061
MEDICARE PTAN
WA
01
—
G8878127
MEDICARE PTAN
WA
Enumeration date
07/19/2005
Last updated
09/16/2025
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