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General NPI Number Information
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NPI Number | 1992971667
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Entity Type | Individual
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Provider Name | CRAIG BROOKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 4033 TALBOT RD S STE 520
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City | RENTON
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State | WA
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Zip | 98055-5774
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Country | US
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Telephone | 425-690-3586
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Fax | 425-690-9586
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Provider Business Mailing Address
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Address Line | 3600 LIND AVE SW SUITE 100 ATTN CREDENTIALING
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City | RENTON
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State | WA
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Zip | 98057-4970
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Country | US
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Telephone | 425-690-2715
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 57011937
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD60222595
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License Number State | WA
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