Healthcare Provider Details

I. General information

NPI: 1346694890
Provider Name (Legal Business Name): ERICA BETH BRANDT PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2016
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 37TH AVE S
SEATTLE WA
98118-1609
US

IV. Provider business mailing address

1200 12TH AVE S STE 901
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-461-6957
  • Fax: 206-461-7810
Mailing address:
  • Phone: 206-548-3114
  • Fax: 206-262-0859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY60959415
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: