Healthcare Provider Details

I. General information

NPI: 1497215404
Provider Name (Legal Business Name): BRIANNA CASE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 PORTAL WAY
FERNDALE WA
98248-7833
US

IV. Provider business mailing address

6060 PORTAL WAY
FERNDALE WA
98248-7833
US

V. Phone/Fax

Practice location:
  • Phone: 360-676-6177
  • Fax: 360-671-3574
Mailing address:
  • Phone: 360-676-6177
  • Fax: 360-671-3574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF344531-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61627719
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number61623430
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: