Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP60322605 | WA |
NPI | 1003251273 |
---|---|
Provider Name | Jennifer Laura Branham |
First Address | Seattle, WA 98133-8400 |
Second Address | Seattle, WA 98133-8400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2013 |
Last Update Date | 01/05/2013 |