Healthcare Provider Details

I. General information

NPI: 1124913918
Provider Name (Legal Business Name): BRANDEN ROOSEVELT THORNTON RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

6715 E UNION AVE UNIT 305
DENVER CO
80237-3130
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3000
  • Fax:
Mailing address:
  • Phone: 719-464-9150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberLR61603215
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: