Brigham, Carol Mae
Brigham, Carol Mae is an individual health care provider with primary practice located at 614 Division St # Ms -19 , Port Orchard WA 98366-4614. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Brigham, Carol Mae can be contacted via phone (360) 337-4625.Contact Information
Primary practice address
614 Division St # Ms -19
Port Orchard WA 98366-4614
Phone: (360) 337-4625
Fax: (360) 337-4704
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | CP00001469 | Washington |
Profile Details
| NPI number | 1023642659 |
|---|---|
| LBN Legal business name | Brigham, Carol Mae |
| Credentials | SUDP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2020 |
| Last updated | Nov 27th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023642659 | NPPES |
| Washington | MEDICAID | 090515 |
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