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General NPI Number Information
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NPI Number | 1821078080
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Entity Type | Individual
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Provider Name | BRENT B SAETRUM MD
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Gender | Male
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Dates
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Enumeration Date | 01/21/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 5000 HOPYARD ROAD
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City | PLEASANTON
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State | WA
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Zip | 94588
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Country | US
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Telephone | 925-251-6917
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Fax | 925-924-0506
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Provider Business Mailing Address
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Address Line | 10184 NE GARIBALDI LOOP
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City | BAINBRIDGE ISLAND
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State | UT
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Zip | 98110
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Country | US
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Telephone | 206-855-4778
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | K4994
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License Number State | TX
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