Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OP60730964 | WA |
NPI | 1003234113 |
---|---|
Provider Name | Jinlin Brendel |
First Address | Port Angeles, WA 98362-6219 |
Second Address | Port Angeles, WA 98362-6219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2014 |
Last Update Date | 20/12/2021 |