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General NPI Number Information
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NPI Number | 1902883002
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Entity Type | Individual
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Provider Name | GEORGE M BRENNAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 700 LILLY ROAD N.E. GROUP HEALTH OLYMPIA MEDICAL CENTER
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City | OLYMPIA
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State | WA
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Zip | 98506-5115
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Country | US
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Telephone | 360-923-7530
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Fax |
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Provider Business Mailing Address
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Address Line | 700 LILLY ROAD N.E. GROUP HEALTH OLYMPIA MEDICAL CENTER
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City | OLYMPIA
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State | WA
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Zip | 98506-5115
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Country | US
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Telephone | 360-923-7530
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 01048762A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD60057929
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License Number State | WA
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