Provider Demographics
NPI:1427437110
Name:GILBERT, BRENNAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRENNAN
Middle Name:
Last Name:GILBERT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 N COMMERCIAL ST
Mailing Address - Street 2:STE 1410
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4450
Mailing Address - Country:US
Mailing Address - Phone:360-540-0375
Mailing Address - Fax:
Practice Address - Street 1:119 N COMMERCIAL ST
Practice Address - Street 2:STE 1410
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4450
Practice Address - Country:US
Practice Address - Phone:360-540-0375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2300-INACTIVE STATUS103TC0700X
WAPY60334956103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical