Mark T. Brakstad, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00029189 Issued in WA

Practice address

1560 N 115TH St
Suite 102
Seattle, WA 98133-8414

Phone

(206) 363-2882

Fax

(206) 363-4172

NPI assigned

May 19, 2006

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1881648475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 N 115TH ST",
            "address_2": "SUITE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338414",
            "telephone_number": "206-363-2882",
            "fax_number": "206-363-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKSTAD",
        "first_name": "MARK",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00029189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Houghton Brajtbord
• Julie Brake, M.A.
• Laura Ann Brake
• Mari M Brake, AUD., CCC-A
• Scott Charles Brakenridge, MD
• Candace Lorraine Braley, MA;LMHC
• Alicia Barbara Braman
• Lindsay Braman
• Juliet Bramante
• Nathan Bramel, LMT

• Surgery Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.