MEDICARE: TONI BRASSFIELD

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	207R00000X	Internal Medicine Physician	OP61585443	WA

General Provider Information

NPI Number	:	1407420128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI BRASSFIELD

Provider Business Mailing Address
First Line	:	PO BOX 50095
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98145-5095
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST # 356421
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-2352
Country	:	US
Telephone Number	:	206-543-3605
Fax Number	:

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

Provider Enumeration Date	:	05/17/2021
Last Update Date	:	05/14/2025

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Directions to “ TONI BRASSFIELD ” Practice Location

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