Brenda Polite, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD 00042918 Issued in WA

Practice address

210-43 Devereese Rd
Chehalis, WA 98532-9049

Phone

(360) 269-1886

NPI assigned

Oct 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1073064580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210-43 DEVEREESE RD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985329049",
            "telephone_number": "360-269-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210-43 DEVEREESE RD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985329049",
            "telephone_number": "360-269-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITE",
        "first_name": "BRENDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD 00042918",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G69363",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amir M Piranfar, PHARM.D.
• Tracy Plant, RN
• Robert D Poaster, CRNA
• Darlene Poe
• Donna J Poe
• Sue Ann Poppe, SLPA
• Derick Aaron Potter, ARNP
• Rachael Marie Potter, RN
• James Kyle Pratt, CDPT
• Traci Lynn Prayner, CRNA

• Family Medicine Physician in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.