Provider Demographics
NPI:1346525284
Name:BUCCI, BROOKE ANN (CNM, ARNP)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANN
Last Name:BUCCI
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60141
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98160-0141
Mailing Address - Country:US
Mailing Address - Phone:240-298-4235
Mailing Address - Fax:
Practice Address - Street 1:900 PACIFIC AVE STE 501
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4189
Practice Address - Country:US
Practice Address - Phone:425-683-0500
Practice Address - Fax:425-258-7540
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR144898176B00000X
WAAP61306264176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife