Healthcare Provider Details

I. General information

NPI: 1801708946
Provider Name (Legal Business Name): GRANT BREMER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 HAXTON WAY
BELLINGHAM WA
98226-9279
US

IV. Provider business mailing address

2845 HAXTON WAY
BELLINGHAM WA
98226-9279
US

V. Phone/Fax

Practice location:
  • Phone: 360-483-8127
  • Fax:
Mailing address:
  • Phone: 360-483-8127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: