Brandon Trent Broady, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00018093 Issued in WA

Practice address

3501 Shelby Rd. Suite C
Lynnwood, WA 98087

Phone

(425) 745-9052

Fax

(425) 745-3372

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Serene Lake Massage

  • Health Service Clinic/Center
  • Mukilteo, WA
  • NPI 1821254442
  NPD (past)
• Serene Lake Massage Therapy

  • Specialist
  • Lynnwood, WA
  • NPI 1619003316
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043361900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 CENTER RD",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982044758",
            "telephone_number": "425-290-6024",
            "fax_number": "425-290-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 SHELBY RD. SUITE C",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98087",
            "telephone_number": "425-745-9052",
            "fax_number": "425-745-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADY",
        "first_name": "BRANDON",
        "middle_name": "TRENT",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00018093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tahnee Bridgford
• Kylen Brief, LSWAIC
• Joy Carol Briggs
• Patricia Alice Brinkley, LMHC
• Brandy Brisbin
• Seth Etan Bronstein, OD
• Brookdale Home Health, LLC
• Brookdale Senior Living Communities, Inc.
• Jessica Katherine Brooks, LPN
• Ashley Nicole Hilger Brothers, LMP

• Specialist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.