Individual
NISSA BRANDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
8821 51ST AVE NE, MARYSVILLE, WA 98270
(360) 653-3140
(360) 657-4103
Mailing address
7726 51ST AVE NE, MARYSVILLE, WA 98270-3810
(360) 202-4669
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00023234
WA
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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