Provider Demographics
NPI:1730653775
Name:LESTER, BRANDI RAE (CPHT)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:RAE
Last Name:LESTER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 GOLDFINCH ST APT C
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4783
Mailing Address - Country:US
Mailing Address - Phone:619-672-5935
Mailing Address - Fax:
Practice Address - Street 1:2326 GOLDFINCH ST APT C
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4783
Practice Address - Country:US
Practice Address - Phone:619-672-5935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-13
Last Update Date:2019-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000050463183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician