Provider Demographics
NPI:1124284237
Name:TRAPANI, BRENDA G (LMP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:G
Last Name:TRAPANI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 E ISAACS AVE
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2206
Mailing Address - Country:US
Mailing Address - Phone:509-525-0300
Mailing Address - Fax:509-525-2458
Practice Address - Street 1:1618 E ISAACS AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2206
Practice Address - Country:US
Practice Address - Phone:509-525-0300
Practice Address - Fax:509-525-2458
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00005059174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist