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General NPI Number Information
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NPI Number | 1598924409
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Entity Type | Individual
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Provider Name | ALTHEA LYNN BRANDIS MA
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Gender | Female
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 924 1/2 FIRST STREET SUITE B
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City | SNOHOMISH
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State | WA
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Zip | 98290
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Country | US
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Telephone | 206-227-6139
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Fax |
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Provider Business Mailing Address
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Address Line | 23532 13TH PL W
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City | BOTHELL
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State | WA
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Zip | 98021-9495
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Country | US
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Telephone | 206-227-6139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60237548
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License Number State | WA
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