Provider Information for 1538524921
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BRENT PRITCHARD LSWAIC
Sex: Male
NPI: 1538524921
Last Updated: 2021-04-26
Certification Date: 2021-04-26
Certification Date: 2021-04-26
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1538524921 | ||||||||||||
| Enumeration Date | 2015-12-29 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 4526 FEDERAL AVE # MS 11 EVERETT, WA 98203-2132 United States Phone: 425-349-6400 | Fax: | ||||||||||||
| Primary Practice Address | 4526 FEDERAL AVE # MS 11 EVERETT, WA 98203-2132 United States Phone: 425-349-6200 | Fax:425-392-6300 | ||||||||||||
| Secondary Practice Address(es) | 7440 W MARGINAL WAY S | ||||||||||||
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