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NPI Code Detail

MEDICARE: BRENDA L POWELL MD

MEDICARE: BRENDA L POWELL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD60341332WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194800565
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA L POWELL MD
Provider Business Mailing Address
First Line : 243511 HIGHWAY 101
Second Line :
City : PORT ANGELES
State : WA
Zip : 98363-9472
Country : US
Telephone Number : 360-452-6252
Fax Number :
Provider Business Practice Location Address
First Line : 243511 HIGHWAY 101
Second Line :
City : PORT ANGELES
State : WA
Zip : 98363-9472
Country : US
Telephone Number : 360-452-6252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 11/13/2023

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Directions to “ BRENDA L POWELL MD” Practice Location

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