Provider Demographics
NPI:1851529085
Name:AMSDEN, BRANDI KATHLEEN (LMP)
Entity type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:KATHLEEN
Last Name:AMSDEN
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 1:755 S GRAND AVE
Mailing Address - Street 2:#3
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-2161
Mailing Address - Country:US
Mailing Address - Phone:509-592-3158
Mailing Address - Fax:
Practice Address - Street 1:755 S GRAND AVE
Practice Address - Street 2:#3
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-2161
Practice Address - Country:US
Practice Address - Phone:509-592-3158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60014486175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath