Brandis, Jason Immanuel

Brandis, Jason Immanuel is an individual health care provider with primary practice located at 1956 Ne Kresky Ave , Chehalis WA 98532-2307. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Brandis, Jason Immanuel can be contacted via phone (360) 740-4380.

Contact Information

Primary practice address
1956 Ne Kresky Ave Chehalis WA 98532-2307
Phone: (360) 740-4380
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 61077105 Washington

Profile Details

NPI number 1477161552
LBN Legal business name Brandis, Jason Immanuel
Credentials SUDPT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2020
Last updated Feb 24th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477161552 NPPES
Washington MEDICAID 2161081

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