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Individual

MS. BROOKE VANDER POL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1708 YAKIMA AVE, SUITE 203, TACOMA, WA 98405-5307
(253) 382-8150
Mailing address
1708 YAKIMA AVE, SUITE 203, TACOMA, WA 98405-5307
(253) 382-8150

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP60074105
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0338484
L&I
WA
01
G8936806
MEDICARE
WA
Enumeration date
02/11/2009
Last updated
06/18/2015
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