Individual
MRS. JEAN BROCKENBROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
16411 NE 24TH ST, BELLEVUE, WA 98008-2427
(425) 456-5705
(425) 456-5702
Mailing address
3630 HUNTS POINT RD, HUNTS POINT, WA 98004-1114
(425) 454-6432
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00038983
WA
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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