Provider Demographics
NPI:1588692693
Name:BRANDFORD, HAROLD GILBERT
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:GILBERT
Last Name:BRANDFORD
Suffix:
Gender:M
Credentials:
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 24552
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0552
Mailing Address - Country:US
Mailing Address - Phone:206-328-0838
Mailing Address - Fax:206-328-8224
Practice Address - Street 1:2011 18TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-2150
Practice Address - Country:US
Practice Address - Phone:206-328-0838
Practice Address - Fax:206-328-8224
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA17469207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1061712OtherDSHS
WA116357OtherL&I
WAA04131Medicare UPIN
WA116357OtherL&I