Healthcare Provider Details

I. General information

NPI: 1558532150
Provider Name (Legal Business Name): ERIK STANTON BRAND MD, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2008
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13353 NE BEL RED RD STE 102
BELLEVUE WA
98005-2329
US

IV. Provider business mailing address

PO BOX 3382
BELLEVUE WA
98009-3382
US

V. Phone/Fax

Practice location:
  • Phone: 425-230-3131
  • Fax: 425-214-1252
Mailing address:
  • Phone: 425-230-3131
  • Fax: 425-214-1252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD60289757
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD60289757
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: