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Individual

JORDAN ALAN BROCAILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN, FNP-C

Contact information

Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61217999
WA
363LF0000X
Family Nurse Practitioner
95015500
CA
363LF0000X
Family Nurse Practitioner
AP61217999
WA

Other

Enumeration date
01/29/2021
Last updated
03/28/2023
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