Basic Information
| Provider Information | |||||||||
| NPI: | 1780746859 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRENDELL | ||||||||
| FirstName: | MARLENE | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 190 | ||||||||
| Address2: | |||||||||
| City: | ODESSA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991590190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099822614 | ||||||||
| FaxNumber: | 5099822159 | ||||||||
| Practice Location | |||||||||
| Address1: | 510 E. AMENDE | ||||||||
| Address2: | |||||||||
| City: | ODESSA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 99159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099822614 | ||||||||
| FaxNumber: | 5099822159 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 30005375 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.