Provider Demographics
NPI:1043292808
Name:BRENNAN, HEATHER M (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:M
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-0421
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:509-227-7070
Practice Address - Street 1:2020 E 29TH AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3917
Practice Address - Country:US
Practice Address - Phone:509-626-9400
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2024-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00040078207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAH58832Medicare UPIN