Healthcare Provider Details

I. General information

NPI: 1225725344
Provider Name (Legal Business Name): BRANLO ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 166TH PL NE STE 202A
ARLINGTON WA
98223-8403
US

IV. Provider business mailing address

1286 THALEN DR
LYNDEN WA
98264-9314
US

V. Phone/Fax

Practice location:
  • Phone: 360-305-9716
  • Fax:
Mailing address:
  • Phone: 360-319-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BRANDY VANDEKOP
Title or Position: PRESIDENT/ ADMINISTRATOR
Credential: MBA
Phone: 360-319-1980