Individual
ANASTASIA MARIE BRENCICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
919 3RD ST STE 103, LANGLEY, WA 98260-9228
(360) 221-8415
Mailing address
PO BOX 1503, LANGLEY, WA 98260-1503
(360) 221-8415
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00009346
WA
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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