MEDICARE: MR. ANTHONY BRUNER MSW

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
1	104100000X	Social Worker	RC60022476	WA

General Provider Information

NPI Number	:	1265760748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY BRUNER MSW

Provider Business Mailing Address
First Line	:	4701 45TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-3921
Country	:	US
Telephone Number	:	206-523-3727
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 W HARRISON ST STE 370
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98119-4116
Country	:	US
Telephone Number	:	206-691-2461
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2009
Last Update Date	:	11/22/2009

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