Individual
MIRANDA TAYLOR IVAN BRANSTOOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1035 116TH AVE NE, BELLEVUE, WA 98004-4604
(425) 455-2015
Mailing address
PO BOX 4069, EVERETT, WA 98204-0007
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
57.249423
OH
207L00000X
Anesthesiology Physician
Primary
MD61520802
WA
Other
Enumeration date
03/25/2020
Last updated
09/18/2024
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