Individual
MR. WALTER BRODIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN BSN
Contact information
Practice address
1514 S LAVENTURE RD, MOUNT VERNON, WA 98274-6034
(360) 428-6125
(360) 428-6164
Mailing address
1514 S LAVENTURE RD, MOUNT VERNON, WA 98274-6034
(360) 428-6125
(360) 428-6164
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN 00085749
WA
Other
Enumeration date
12/07/2012
Last updated
12/07/2012
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