Freeman, Braidon Forrest
Freeman, Braidon Forrest is an individual health care provider with primary practice located at 105 W 8Th Ave Ste 200 , Spokane WA 99204-2318. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Freeman, Braidon Forrest can be contacted via phone (509) 624-9112.Contact Information
Primary practice address
105 W 8Th Ave Ste 200
Spokane WA 99204-2318
Phone: (509) 624-9112
Fax: (503) 297-8148
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA 01014 | Oregon |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA61281463 | Washington |
Profile Details
| NPI number | 1104812981 |
|---|---|
| LBN Legal business name | Freeman, Braidon Forrest |
| Credentials | PA C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2005 |
| Last updated | Aug 1st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104812981 | NPPES |
| Oregon | MEDICAID | 500604585 |
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