Provider Demographics
NPI:1902244205
Name:BRAUNER, ISAAC A (DO)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:A
Last Name:BRAUNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3550
Mailing Address - Country:US
Mailing Address - Phone:509-853-1082
Mailing Address - Fax:509-573-6275
Practice Address - Street 1:102 E 2ND ST
Practice Address - Street 2:
Practice Address - City:NACHES
Practice Address - State:WA
Practice Address - Zip Code:98937-9743
Practice Address - Country:US
Practice Address - Phone:509-653-2235
Practice Address - Fax:509-452-5224
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60674574207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0463879OtherLABOR AND INDUSTRIES
WA2033753Medicaid