MEDICARE: BRANDON LEE WEIMER LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LH61427092	WA

General Provider Information

NPI Number	:	1801782701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON LEE WEIMER LMHC

Provider Business Mailing Address
First Line	:	1416 E SUMACH ST
Second Line	:
City	:	WALLA WALLA
State	:	WA
Zip	:	99362-8984
Country	:	US
Telephone Number	:	801-643-6242
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 E MAIN ST STE 304
Second Line	:
City	:	WALLA WALLA
State	:	WA
Zip	:	99362-1900
Country	:	US
Telephone Number	:	509-790-6561
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	06/16/2025

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