Active NPI
Anastasia Marie Brencick, LMP
- Specialist
- Langley, WA
National Provider Identifier
1891841748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00009346
- Practice address
- 919 3Rd St Ste 103
Langley, WA 98260-9228 - Phone
- (360) 221-8415
- NPI assigned
- Jan 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00009346 | WA | Primary |
Addresses
Primary practice location
919 3Rd St Ste 103
Langley, WA 98260-9228
Mailing address
PO Box 1503
Langley, WA 98260-1503
Phone (360) 221-8415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00009346 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891841748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1503",
"city": "LANGLEY",
"state": "WA",
"postal_code": "982601503",
"telephone_number": "360-221-8415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "919 3RD ST STE 103",
"city": "LANGLEY",
"state": "WA",
"postal_code": "982609228",
"telephone_number": "360-221-8415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENCICK",
"first_name": "ANASTASIA",
"middle_name": "MARIE",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00009346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Langley, WA
- Tim Batiste, LAC
- Bayview Vision Clinic
- Paulette Lytle Becker, R.N., M.S.N.
- Gina Valenti Bernal, DPT, ATC
- Braden H Giswold DDS PLLC (Saratoga Dental)
- Teresa Bujacich, ND, LAC.
- Kyla Burford, MSW, LICSW
- Faith Brayton Bushby, LMP
- Vanessa Cameron, LAC
- Carrie Pope, MSW, Licsw, PLLC (Carrie Pope, MSW, LICSW)
Sources for this page
- 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.