| Doctor Name: | MS. MARY BRENCICK |
| NPI Number: | 1063654523 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | LW00008598 |
| Business Practice Address: | 1300 Ne Goldie St Oak Harbor, WA - 982774832 |
| Business Phone Number: | 3602404043 |
| Business Fax Number: | |
| Mailing Address: | 816 Casino Dr, GREENBANK |
| State: | WA |
| Postal Code: | 982539709 |
| Phone Number: | 3606789294 |
| Fax Number: | |
| NPI Enumeration Date: | 03/30/2009 |
| NPI Last Update Date: | 03/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LW00008598 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |